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Unplanned Pregnancy, Fetal Loss, and Epilepsy

JAMA Neurology; ePub 2018 Oct 15; Herzog, et al

In the recent Epilepsy Birth Control Registry survey study, results indicated that unplanned pregnancy may double the risk of spontaneous fetal loss (SFL) in women with epilepsy. Interpregnancy interval <1 year and conception age <18 years or >37 years were also factors. The Epilepsy Birth Control Registry conducted a web-based, retrospective survey between 2010 and 2014. Researchers gathered demographic, epilepsy, antiepileptic drug (AED), contraceptive, and reproductive data from 1,144 women with epilepsy in the community between ages 18 and 47 years. They found:

  • There were 530 of 794 unplanned pregnancies (66.8%) and 264 of 794 planned pregnancies (33.2%).
  • The risk for SFL in 653 unaborted pregnancies in women with epilepsy was greater for unplanned (n=137 of 391; 35.0%) than planned (n=43 of 262; 16.4%) pregnancies.
  • Interpregnancy interval and maternal age, but not AED category, were also associated.
  • The risk was greater when interpregnancy interval <1 year (n=56 of 122; 45.9%) vs >1 year (n=56 of 246; 22.8%).


Herzog AG, Mandle HB, MacEachern DB. Association of unintended pregnancy with spontaneous fetal loss in women with epilepsy. Findings of the Epilepsy Birth Control Registry. [Published online ahead of print October 15, 2018]. JAMA Neurology. doi:10.1001/jamaneurol.2018.3089.