Seizure-Free Status Prior to Conception Lowers Odds of Recurrence During Pregnancy

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Prior studies have suggested that women with epilepsy who are seizure free ≥9 months prior to pregnancy have a high likelihood of remaining seizure free during pregnancy.
The following article is part of conference coverage from the 2018 American Academy of Neurology Annual Meeting in Los Angeles, California. Neurology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from AAN 2018.

LOS ANGELES – Women who were seizure free prior to conception have a low risk for seizure recurrence during pregnancy, according to research presented at the 70th annual American Academy of Neurology meeting, held April 21-27, 2018, in Los Angeles, California.

Page Pennell, from the Department of Neurology at Brigham and Women’s Hospital, and colleagues evaluated the likelihood of maintaining freedom from seizures during pregnancy and postpartum in women with epilepsy.

The Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD) study is a National Institutes of Health-funded, prospective investigation of outcomes for mother and child. The study enrolled 351 pregnant women with epilepsy who participated in MONEAD and 109 nonpregnant women with epilepsy. Baseline seizure frequency and antiepileptic drug regimen were observed.

For 9 months prior to conception, 164 of 351 (46.7%) pregnant women with epilepsy were seizure free compared with 45% of the nonpregnant women with epilepsy. Of the participants who were seizure free, 84.8% of pregnant women with epilepsy remained seizure free during pregnancy and 87.8% were seizure free during 9 months postpartum.

In the nonpregnant women with epilepsy group, 85.7% remained seizure free for the 9 months after enrollment, and 83.7% remained seizure free during the subsequent 9 months.

The findings suggest that women who are seizure free prior to conception have a low risk for seizure recurrence during or after pregnancy. “Future analyses will include seizure frequency changes in all [women with epilepsy], with analysis of potential risk factors, including type and dosing of [antiepileptic drugs], seizure types, time to last seizure, and specific time windows,” concluded the researchers.

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Pennell P, French J, May R, et al. Maintaining seizure freedom during pregnancy and postpartum: findings from the MONEAD study. Presented at: 2018 AAN Annual Meeting; April 21-27, 2018; Los Angeles, CA. Abstract S11.