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Title: Epileptic seizure control during and after pregnancy in Australian women.
Austin Authors: Vajda, Frank J E;O'Brien, Terence J;Graham, Janet E;Hitchcock, Alison A;Perucca, Piero ;Lander, Cecilie M;Eadie, Mervyn J
Affiliation: Department of Neuroscience, Monash University, Melbourne, Victoria, Australia..
Departments of Medicine and Neurosciences, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia..
Royal Brisbane and Women's Hospital and School of Medicine and Biomedical Science, University of Queensland, Brisbane, Queensland, Australia..
Comprehensive Epilepsy Program
Medicine (University of Melbourne)
Department of Neurology, Alfred Health, Melbourne, Victoria, Australia..
Issue Date: Jun-2022
Date: 2022-03-07
Publication information: Acta Neurologica Scandinavica 2022; 145(6): 730-736
Abstract: To study factors that affected previous epileptic seizure control throughout pregnancy, during labour, and in the post-natal weeks. 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. 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. Obtaining full seizure control before pregnancy appeared to be the main factor in maintaining seizure freedom during pregnancy, labour and the post-natal weeks.
DOI: 10.1111/ane.13609
Journal: Acta neurologica Scandinavica
PubMed URL: 35257362
PubMed URL:
Type: Journal Article
Subjects: epilepsy
post-natal period
seizure freedom
Appears in Collections:Journal articles

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