Epilepsy, Intellectual and Developmental Disabilities, and Contraception in U.S. Medicaid Claims Data

Area of Science:

• Reproductive Health
• Neurology
• Public Health

Background:

• Contraceptive access is crucial for reproductive health.
• Epilepsy and intellectual and developmental disabilities (IDD) may influence healthcare decisions.
• Understanding these influences is vital for equitable care.

Purpose of the Study:

• To examine how epilepsy and IDD impact contraceptive provision in females with Medicaid insurance.
• To investigate the interaction between epilepsy and IDD on contraceptive access.

Main Methods:

• Utilized Medicaid claims data from 2016-2021 for females aged 12-51.
• Identified epilepsy and IDD using validated criteria and ICD-10 codes.
• Performed multivariable logistic regression to analyze contraceptive prescription patterns.

Main Results:

• Females with epilepsy were more likely to receive contraceptives (aOR 1.05).
• Females with IDD were less likely to receive contraceptives (aOR 0.57).
• Females with both conditions had intermediate likelihood (aOR 0.83), with significant differences in specific method prescriptions.

Conclusions:

• Epilepsy has a small but significant effect on contraceptive prescription.
• A significant interaction exists between epilepsy and IDD affecting contraceptive provision.
• Tailored approaches may be needed to ensure equitable contraceptive access for these populations.