| Purpose:This study aimed to focus on the selection of contraceptive methods and AEDs,accidental pregnancy rates,contraceptive related concerns,and consultation rates of women with epilepsy(WWE)in child-bearing period in Suzhou.To explore the related factors affecting the unexpected pregnancy of WWE and to provide a basis for strengthening the management of contraception in WWE of child-bearing age.Methods:We conducted an online electronic questionnaire survey on the child-bearing age WWE who visited the epilepsy center of the First Affiliated Hospital of Soochow University from January 1,2019 to October 1,2019.As a control group,we also collected the general information of the hospital medical examination center.The control group and the WWE group matched their sexual life history,and their basic demographic characteristics were similar.Through this case-control study,the data of contraceptive methods,unintended pregnancy rate,and contraceptive-related consultation of the two groups were compared and analyzed.Combining single factor and multivariate logistic regression analysis to analyze the influencing factors of WWE unexpected pregnancy in child-bearing age.Results:1.There were no statistically significant differences in age,ethnicity,education level or sexual history between the 152 WWE and 152 healthy controls of child-bearing age(P>0.05).2.Compared with the control group,the accidental pregnancy rate of WWE in Suzhou was higher(26.40%vs.16.00%;P=0.044),and the satisfaction with the effect of contraception was lower(Z=-3.270;P=0.001).Compared with the control group,the proportion of WWE who did not take any contraceptive measures was higher(47.20%vs.26.40%;P=0.001),and the proportion of hormonal combined with non-hormonal contraception was lower(0%vs.10.40%;P<0.001).There was no statistically significant difference between the two groups in using only hormonal contraception(1.60%vs.2.40%;P=1.000)and non-hormonal contraception(51.20%vs.60.80%;P=0.126).There was no significant difference between the two groups in the degree of receiving contraceptive counseling provided by a specialist(Z=-0.233;P=0.816).3.Univariate analysis showed that the accidental pregnancy rate of WWE in child-bearing age was related to the proportion of people who did not take contraceptive measures(63.64%vs.41.30%;P=0.027),and related to the proportion of non-hormonal contraceptive methods(33.33%vs.57.61%;P=0.017),but not related to the rate of hormonal contraception(3.03%vs.1.09%;P=0.460).The accidental pregnancy rate of WWE was related to the use rate of enzyme-inducing antiepileptic drugs,and the difference was statistically significant(69.70%vs.48.92%;P=0.040).WWE's attention to the interaction between AEDs and contraceptives was not significantly related to WWE's unexpected pregnancy rate,and the difference was not statistically significant(Z=-0.566;P=0.572).The degree to which specialists provide contraception counseling on WWE is inversely related to the WWE pregnancy rate(Z=-2.080;P=0.038).However,the accidental pregnancy rate of WWE was not significantly related to age(P=0.991),education level(P=0.151),and ethnicity(P=0.264).4.Multivariate logistic regression analysis showed that the absence of contraceptive measures was a risk factor for WWE unexpected pregnancy at child-bearing age(OR=2.776;P = 0.029).Consultation with a specialist is a protective factor for WWE unintended pregnancy(OR=0.353;P=0.031).Conclusions:1.The rate of unintended pregnancy in women with epilepsy is higher than in healthy women in Suzhou.Therefore,clinicians should pay attention to the contraceptive problems of women with epilepsy.2.High use rate of enzyme-inducing antiepileptic drugs and the low use rate of non-hormonal contraceptive are two risk factors for unintended pregnancy in women with epilepsy.3.The absence of any contraceptive measures was a risk factor for unintended pregnancy in women with epilepsy of child-bearing age.Therefore,it is recommended to adopt efficient non-hormonal contraception.4.Consultation with a specialist is a protective factor for unintended pregnancy in women with epilepsy.Specialists should regularly provide patients with advice on contraception to reduce the rate of unintended pregnancy. |
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