Abstracts

Rationale: Reproductive health impacts overall health and quality of life. In developing countries like India, women with epilepsy (WWE) face stigmatization and lack opportunities for epilepsy treatment. While social and cultural barriers often prevent WWE from expressing reproductive concerns, most physicians too do not actively pursue patient questioning in this sphere. This study aims to bring attention to reproductive health in Indian WWE. Methods: This quantitative survey carried out at a tertiary care teaching hospital in New Delhi used a comparative cross-sectional design to compare reproductive health of consecutively enrolled 18-45 year old married WWE on antiepileptic treatment for at least one year with married, age and socio-economic status matched healthy non-epileptic women. Women with any mental or physical disability or progressive brain disease were excluded. In addition to demographic and epilepsy related data, a self-developed, validated, structured 31 item tool was used to collect reproductive health data. Descriptive and inferential statistics were applied. Results: Sixty WWE and 60 non-epileptic women were enrolled. Epilepsy had been present for a mean of 13 (1-34) years in WWE and had started at a mean age of 19±8 years. Of the 60 WWE, 36 reported onset of epilepsy prior to marriage but only 14 had disclosed this to their prospective husbands. There was no significant difference in the mean age at marriage between WWE and non-epileptic women. No significant difference was found between the two groups when educational and employment status of their husbands were compared, but WWE were lesser educated (p=0.001) and less often employed (p=0.003) compared to non-epileptic women. BMI and obesity were higher in WWE (p<0.001). Composite scores of reproductive health including marital adjustment, sexual functions, menstrual health and reproductive functions were all significantly lower (p<0.001) in WWE. Higher number of miscarriages (p<0.001) and fewer children (p=0.002) were found in WWE than non-epileptic women. Earlier onset of epilepsy was significantly associated with poor reproductive functions (p=0.02). Generalized seizures impacted reproductive health more than focal seizures (p=0.05). Amongst WWE, obesity was associated with higher marital disharmony and sexual dysfunction (p<0.001). Women with less frequent seizures and in remission had better marital adjustment, sexual function and reproductive functions than those who had more frequent seizures. Conclusions: Reproductive health of Indian WWE is significantly lower as compared to non-epileptic women (p<0.001). Standard of care for WWE should include a sensitive and supportive system which encourages them to discuss these issues more openly. Physicians can improve overall health and quality of life of WWE by helping them deal with these largely closeted problems. Source of funding Nil: