Birth Rates Among Teenagers With Epilepsy in Michigan: A Retrospective Analysis of a Medicaid-Insured Cohort From 2016-2022

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OBJECTIVE: Teenage pregnancy rates are high in the United States. Teenagers with epilepsy are at a particular health risk due to challenging transitions of care and unique considerations for contraception as well as at increased risk for fetal and maternal complications in pregnancy. The objective of this study was to explore the live birth rate among teenaged girls with epilepsy in Michigan. METHODS: In this retrospective open-cohort epidemiological study, we estimated the live birth rate and identified predictors for births among Medicaid-insured teenaged girls (aged 15-19 y) with epilepsy in Michigan, using administrative data from the Michigan Children's Special Health Care Services Program from 2016-2022. RESULTS: Among teenaged girls with epilepsy in Michigan, the birth rate was 1.6 per 100 population. Significant factors associated with giving birth (vs not) included use of fewer antiseizure medications, lack of contraceptive use, and low annual household income. CONCLUSION: Given the risk factors identified (eg, no use of contraceptives, low income), teenaged girls with epilepsy may need greater access to care, resources, and/or support than teenaged girls without epilepsy. Our data suggest that targeted interventions to facilitate access to contraceptives could be beneficial. Improving data tracking and diagnosis coding practices will be important for the future study of the birth rate among teenaged girls with epilepsy.

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