@article{86f08f97f76b49a48812bbf94b5f5756,
title = "Epileptic seizure control during and after pregnancy in Australian women",
abstract = "Objectives: To study factors that affected previous epileptic seizure control throughout pregnancy, during labour, and in the post-natal weeks. Materials & Methods: Analysis of data concerning seizure freedom that was available at various stages of 2337 pregnancies in the Raoul Wallenberg Australian Pregnancy Register of Antiepileptic Drugs, mainly employing multiple variable logistic regression techniques. Results: Based on data available at the outset of pregnancy, the risk of seizure-affected that is, not seizure-free pregnancy was statistically significantly (p <.05) higher in pregnancies where there was previously uncontrolled epilepsy (78.1% vs. 20.8%) and focal epilepsy (51.3% vs. 39.7%), and decreased with later onset-age epilepsy (41.8% vs. 52.2% with onset before age 13 years), The risk did not differ between initially antiseizure medication (ASM)-treated or untreated pregnancies. For epilepsy receiving ASM therapy, 90.6% of 160 pregnancies of women with uncontrolled focal epilepsy that began before the age of 13 were seizure-affected. None of the above factors influenced the risk of seizures during labour, though having seizures during pregnancy increased the hazard (3.93 vs. 0.6%). Either ASM-treated pregnancy or labour being seizure-affected increased the risk of post-partum period seizures (33.0% vs. 6.67% for both stages being seizure-free). Use of particular ASMs had no statistically significant effect on the seizure control situation at any of the pregnancy stages studied. Conclusions: Obtaining full seizure control before pregnancy appeared to be the main factor in maintaining seizure freedom during pregnancy, labour and the post-natal weeks.",
keywords = "epilepsy, labour, post-natal period, pregnancy, seizure freedom",
author = "Vajda, {Frank J.E.} and O{\textquoteright}Brien, {Terence J.} and Graham, {Janet E.} and Hitchcock, {Alison A.} and Piero Perucca and Lander, {Cecilie M.} and Eadie, {Mervyn J.}",
note = "Funding Information: FJE Vajda has received research support for the Australian Pregnancy Register from the Epilepsy Society of Australia, NHMRC, RMH Neuroscience Foundation, Epilepsy Action Australia, Sanofi‐Aventis, Eisai, and UCB Pharma. T O{\textquoteright}Brien has received research support from the Epilepsy Society of Australia, NHMRC, RMH Neuroscience Foundation, Sanofi‐Aventis, UCB Pharma, Sci‐Gen and Eisai. P. Perucca is currently supported by the National Health and Medical Research Council (APP1163708), the Epilepsy Foundation, The University of Melbourne, Monash University, Brain Australia, and the Weary Dunlop Medical Research Foundation. He has received speaker honoraria or consultancy fees paid to his institution from Chiesi, Eisai, LivaNova, Novartis, Sun Pharma, Supernus, and UCB Pharma, and is an Associate Editor for Epilepsia Open. JE Graham, AA Hitchcock, CM Lander, and MJ Eadie have no relevant conflicts of interest. Funding Information: We are grateful to professional and lay colleagues and to various bodies for referring patients to the APR, and also to the Scientific Advisory Board and the Ethical Research Committees of St. Vincent{\textquoteright}s Hospital, Monash Medical Centre, the Royal Melbourne Hospital and other relevant institutions for continuing ethics oversight of the APR. Over its years, The Epilepsy Society of Australia, The Royal Melbourne Hospital Neuroscience Foundation, Epilepsy Action Australia, the NHMRC and the pharmaceutical companies Sanofi‐Aventis, UCB Pharma, and Eisai and have provided financial support towards the maintenance of the APR. Publisher Copyright: {\textcopyright} 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd",
year = "2022",
month = jun,
doi = "10.1111/ane.13609",
language = "English",
volume = "145",
pages = "730--736",
journal = "Acta Neurologica Scandinavica",
issn = "0001-6314",
publisher = "Wiley-Blackwell",
number = "6",
}