Fertility rate and determinants of fertility among women with epilepsy at Debre Birhan Referral Hospital, North Shewa, Ethiopia

Abstract

Background Fertility is defined as the number of live births per thousand women. There are increased reproductive problems among women with epilepsy (WWE) who are taking antiepileptic drugs (AEDs). Literatures indicate that there is a greater risk of pregnancy complications related to seizures and the drugs taken by these patients. Therefore, the main aim of this research was to determine the fertility rate and determinants of fertility among women with epilepsy at Debre Birhan Referral Hospital, North Shewa, Ethiopia. Methods A hospital-based cross-sectional study was conducted, and a total of 88 reproductive-aged women with epilepsy were interviewed about their pregnancy and birth histories. The authors’ questionnaire was used to assess the sociodemographic data and clinical characteristics of the patients. The clinical data were also crosschecked with the medical records. Results Of the 88 women with epilepsy included in this study, 35 (39.8%) were married, and 45 (51.1%) had a history of pregnancy. The mean number of live births among women with epilepsy was 3.15 (± 1.41 SD). Of the total pregnancies, approximately one-third were complicated, six (13.3%) ended up with abortion, 2 (4.4%) were stillborn, and 5 (11.1%) had birth defects. Among the 5 (11.1%) birth defects that occurred, 2 (4.4%) were hydrocephalus, while 3 (6.7%) were neural tube defects. All stillbirths and/or abortions were among women with a body mass index (BMI) less than 18.5 kg/m². A total of 33.3% of the deliveries were at home, and 89.7% of the health facility deliveries were delivered by cesarean section. Slightly fewer than half 20, (44.4%) of the pregnancies were unplanned. Contraceptive failure was reported by 15.6% (7/45) of the women. Pills and condoms were reported as methods that failed to protect against pregnancy. The fertility rate of reproductive-aged women with epilepsy for the three years preceding the data collection period was 0.4 per 1000 women. Conclusion The fertility rate of women with epilepsy was lower than that of the general population. Fetal loss, congenital malformation, and contraceptive failure were observed among women with epilepsy. Careful preconception care might be beneficial for attaining a healthy weight and adjusting antiepileptic drugs for women with epilepsy. A specific study for assessing the reasons for this disparity is recommended.