Management issues for women with epilepsy - Focus on pregnancy (an evidence-based review): I. Obstetrical complications and change in seizure frequency: Report of the Quality Standards Subcommittee and Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and the American Epilepsy Society

Cynthia L. Harden, Jennifer Hopp, Tricia Y. Ting, Page B. Pennell, Jacqueline A. French, W. Allen Hauser, Samuel Wiebe, Gary S. Gronseth, David Thurman, Kimford J. Meador, Barbara S. Koppel, Peter W. Kaplan, Julian N. Robinson, Barry Gidal, Collin A. Hovinga, Andrew N. Wilner, Blanca Vazquez, Lewis Holmes, Allan Krumholz, Richard FinnellClaire Le Guen

Research output: Contribution to journalArticlepeer-review

Abstract

A committee assembled by the American Academy of Neurology (AAN) reassessed the evidence related to the care of women with epilepsy (WWE) during pregnancy, including the risk of pregnancy complications or other medical problems during pregnancy, change in seizure frequency, the risk of status epilepticus, and the rate of remaining seizure-free during pregnancy. The committee evaluated the available evidence according to a structured literature review and classification of relevant articles. For WWE who are taking antiepileptic drugs (AEDs), there is probably no substantially increased risk (>2 times expected) of cesarean delivery or late pregnancy bleeding, and probably no moderately increased risk (>1.5 times expected) of premature contractions or premature labor and delivery. There is possibly a substantially increased risk of premature contractions and premature labor and delivery during pregnancy for WWE who smoke. WWE should be counseled that seizure freedom for at least 9 months prior to pregnancy is probably associated with a high likelihood (84-92%) of remaining seizure-free during pregnancy. WWE who smoke should be counseled that they possibly have a substantially increased risk of premature contractions and premature labor and delivery.

Original languageEnglish (US)
Pages (from-to)1229-1236
Number of pages8
JournalEpilepsia
Volume50
Issue number5
DOIs
StatePublished - May 2009

Keywords

  • Complications
  • Epilepsy
  • Guideline
  • Pregnancy
  • Seizure

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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