Prepregnancy Seizure History May Predict Antepartum Seizure Risk

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Women with a history of seizures within 1 year before pregnancy face an increased risk for seizures during pregnancy.
Women with a history of seizures within 1 year before pregnancy face an increased risk for seizures during pregnancy.

Seizures that occur 1 year before pregnancy in women with epilepsy are an indicator for the likelihood of experiencing seizures during pregnancy, according to a study published in Epilepsy Behavior.

In this study, investigators analyzed data recorded in the Australian Pregnancy Register (APR) between 1998 and 2016. The data in the APR reported seizure occurrence among epileptic women before and during pregnancy.

A total of 1939 pregnancies among epileptic women were available for analysis. In this cohort, seizures occurred in 829 pregnancies (42.8%); convulsive seizures occurred in 385 pregnancies (19.9%).

The majority of women with active epilepsy who experienced epileptic seizures a year before pregnancy also experienced seizures during pregnancy (78.4%), and a smaller proportion of patients with inactive epilepsy (22.3%) who experienced seizures 1 year before the pregnancy experienced during-pregnancy seizures (risk ratio, 3.51; 95% CI, 3.13-3.94).

A similar proportion of patients who were initially unexposed to antiepileptic drugs and patients who had a history of antiepileptic drug exposure experienced pregnancy seizures (54.9% and 45.5%, respectively). The investigators found that patients with active epilepsy who were taking polytherapy had a higher seizure rate during pregnancy than those taking monotherapy (84.9% vs 73.5%, respectively; risk ratio, 1.16; 95% CI, 1.07-1.24).

The APR relied on data voluntarily reported by epileptic women; therefore, the researchers found difficulty in verifying seizure occurrences, as these relied primarily on the patient's memory.

In addition to helping epileptic women who are considering pregnancy, the findings of this study emphasize "the desirability of obtaining continuing full seizure control prior to pregnancy."

Reference

Vajda FJE, O'Brien TJ, Graham JE, et al. Predicting epileptic seizure control during pregnancy. Epilepsy Behav. 2017;78:91-95.

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