Document Detail

Polytherapy increases the risk of infertility in women with epilepsy.
MedLine Citation:
PMID:  20938026     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Reproductive capability is an important concern for women with epilepsy (WWE). We aimed to ascertain the magnitude of infertility in a cohort of WWE who were anticipating pregnancy.
METHODS: A prospective cohort of WWE enrolled in the Kerala Registry of Epilepsy and Pregnancy (1998-2007) in the preconception stage. The endpoint was occurrence of pregnancy. They were divided into those who remained infertile (IG group) and those who had become pregnant during the follow-up period (FG).
RESULTS: Out of 375 women followed up for 1-10 years, 231 had pregnancy and 144 remained infertile (38.4%). Pregnancy occurred within 2 years of follow-up for most patients in the FG group. The IG group had higher mean age, lower education, and longer follow-up when compared to the FG group. Infertility was least (7.1%) for those with no antiepileptic drug (AED) exposure and higher (p = 0.001) with AED exposure (31.8% with 1 AED, 40.7% with 2 AED, and 60.3% with 3 or more AED exposure). Those exposed to phenobarbital had significant risk of infertility, but no such trend was observed with valproate or other drugs. On multiple logistic regression, use of 3 AEDs or more (odds ratio [OR] 17.9; 95% confidence interval [CI] 2.14-149.48), older age (OR 1.32; 95% CI 0.84-2.09), and low education (OR 2.91; 95% CI 1.82-4.65) remained as the important predictors of infertility.
CONCLUSION: More than a third (38.4%) of WWE had infertility. The important predictors of infertility were exposure to multiple AEDs, older age, and lower education.
Sapna Cheravalloor Sukumaran; P Sankara Sarma; Sanjeev V Thomas
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Neurology     Volume:  75     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-12     Completed Date:  2010-10-29     Revised Date:  2011-06-03    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1351-5     Citation Subset:  AIM; IM    
Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.
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MeSH Terms
Anticonvulsants / adverse effects*
Chi-Square Distribution
Cohort Studies
Drug Therapy, Combination / adverse effects*
Epilepsy / drug therapy*,  mortality
Infertility / chemically induced*
Kaplan-Meier Estimate
Pregnancy / drug effects*
Retrospective Studies
Risk Factors
Young Adult
Reg. No./Substance:
Comment In:
Neurology. 2010 Oct 12;75(15):1316-7   [PMID:  20938024 ]
Neurology. 2011 Apr 19;76(16):1442; author reply 1442   [PMID:  21502609 ]

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