Comparative Fertility of Women With and Without Epilepsy in the Bamenda Health District (Cameroon): A Matched Cross-Sectional Study
Fécondité Comparée des Femmes Epileptiques et Non Epileptiques dans le District de Bamenda (Cameroun) : Une Etude Transversale Appariée
DOI:
https://doi.org/10.67260/hra.v4i8.7917Keywords:
Epilepsy, Women with epilepsy, Fertility, Reproductive health low- and middle-income countriesAbstract
ABSTRACT
Introduction. Epilepsy affects over 12.5 million women of reproductive age globally, with a disproportionate burden in low- and middle-income countries. Women with epilepsy (WWE) are known to have reduced fertility compared to the general population, but the determinants remain multifactorial and context-specific. This study compared fertility status between WWE and women without epilepsy and identified factors associated with reduced fertility in WWE in the Bamenda Health District (BHD), Cameroon. Method. A hospital-based cross-sectional comparative study was conducted from November 2021 to July 2022. Sixty-one WWE (mean age 30.47 ± 10.41 years) were matched 1:2 with 122 women without epilepsy (mean age 30.98 ± 10.33 years). Fertility was defined as the number of live births. Statistical analyses included Chi-square, Fisher’s exact test, and multivariate logistic regression. Results. WWE had significantly lower fertility, with a mean of 1.28 ± 1.52 live births compared to 2.17 ± 1.82 in controls. Independent predictors of reduced fertility included seizure onset ≤15 years (OR=7.28, p=0.036), early epilepsy diagnosis (OR=8.73, p=0.014), and sexual dysfunction (OR=2.46, p=0.040). Employment was associated with improved fertility outcomes (OR=0.13, p=0.048). Conclusion. WWE in the BHD have significantly reduced fertility compared to women without epilepsy. Early-onset epilepsy and psychosocial factors, particularly sexual dysfunction, play a key role. Strengthening early diagnosis, optimizing treatment, and addressing psychosocial barriers may improve reproductive outcomes in this population.
RÉSUMÉ
Introduction. L'épilepsie touche plus de 12,5 millions de femmes en âge de procréer dans le monde, avec un fardeau disproportionné dans les pays à faible et moyen revenu. Les femmes vivant avec l'épilepsie sont connues pour avoir une fertilité réduite par rapport à la population générale, mais les déterminants restent multifactoriels et spécifiques au contexte. Cette étude a comparé le statut de fertilité entre les femmes vivant avec l'épilepsie et les femmes sans épilepsie, et a identifié les facteurs associés à une fertilité réduite chez les femmes vivant avec l'épilepsie dans le district de santé de Bamenda, au Cameroun. Méthode. Une étude comparative transversale en milieu hospitalier a été menée de novembre 2021 à juillet 2022. Soixante et une femmes vivant avec l'épilepsie (âge moyen 30,47 ± 10,41 ans) ont été appariées selon un ratio de 1:2 à 122 femmes sans épilepsie (âge moyen 30,98 ± 10,33 ans). La fertilité a été définie comme le nombre de naissances vivantes. Les analyses statistiques comprenaient le test du Chi-carré, le test exact de Fisher et la régression logistique multivariée. Résultats. Les femmes vivant avec l'épilepsie présentaient une fertilité significativement plus faible, avec une moyenne de 1,28 ± 1,52 naissance vivante contre 2,17 ± 1,82 chez les témoins. Les facteurs prédictifs indépendants d'une fertilité réduite comprenaient le début des crises à un âge inférieur ou égal à 15 ans (OR = 7,28, p = 0,036), un diagnostic précoce de l'épilepsie (OR = 8,73, p = 0,014) et le dysfonctionnement sexuel (OR = 2,46, p = 0,040). L'emploi était associé à de meilleurs résultats en matière de fertilité (OR = 0,13, p = 0,048). Conclusion. Les femmes vivant avec l'épilepsie dans le district de santé de Bamenda présentent une fertilité significativement réduite par rapport aux femmes sans épilepsie. Le début précoce de l'épilepsie et les facteurs psychosociaux, en particulier le dysfonctionnement sexuel, jouent un rôle clé. Le renforcement du diagnostic précoce, l'optimisation du traitement et la prise en charge des barrières psychosociales pourraient améliorer les résultats en matière de reproduction au sein de cette population.
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