Seizure control in successive pregnancies in Australian women with epilepsy

Frank J.E. Vajda, Terence J. O'Brien, Janet Graham, Alison A. Hitchcock, Piero Perucca, Cecilie M. Lander, Mervyn J. Eadie

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Abstract

Objectives: To investigate control of epileptic seizures during pairs of successive pregnancies in antiseizure medication (ASM)-treated women with epilepsy. Materials and Methods: Analysis of seizure freedom rates during 436 pairs of successive pregnancies in Australian women with epilepsy, in nearly all instances long-standing epilepsy. Result: There was a higher rate of seizure-free second pregnancies compared with first paired pregnancies (63.1% vs. 51.4%; Relative Risk (R.R.) = 1.2277; 95% CI 1.0930, 1.3789) and of seizure-free pre-pregnancy years before second as compared with first paired pregnancies in the same women (63.6% vs. 52.4%; R.R. = 1.2616; 95% CI 1.1337, 1.4040). In 108 women whose ASM therapy was unaltered throughout both of their pregnancies, the seizure-freedom rate was higher in the second of the paired pregnancies (82.4% vs. 69.4%; R.R. = 1.1867, 95% CI 1.0189, 1.3821). Conclusions: Altered ASM therapy after the first of a pair of successive pregnancies did not fully account for the better overall seizure control in the corresponding second pregnancies. Some additional factor may have been in operation, possibly a greater preparedness to undertake a further pregnancy if seizures were already fully controlled.

Original languageEnglish
Pages (from-to)610-614
Number of pages5
JournalActa Neurologica Scandinavica
Volume146
Issue number5
DOIs
Publication statusPublished - Nov 2022

Keywords

  • antiseizure medication
  • epilepsy
  • pregnancy
  • seizure freedom
  • successive pregnancies

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