Pregnancy registries in epilepsy: A consensus statement on health outcomes

K. J. Meador, P. B. Pennell, C. L. Harden, J. C. Gordon, T. Tomson, P. W. Kaplan, G. L. Holmes, J. A. French, W. A. Hauser, P. G. Wells, J. A. Cramer

Research output: Contribution to journalReview articlepeer-review

Abstract

Most pregnant women with epilepsy require antiepileptic drug (AED) therapy. Present guidelines recommend optimizing treatment prior to conception, choosing the most effective AED for seizure type and syndrome, using monotherapy and lowest effective dose, and supplementing with folate. The Epilepsy Therapy Project established the international Health Outcomes in Pregnancy and Epilepsy (HOPE) forum to learn more about the impact of AEDs on the developing fetus, particularly the role of pregnancy registries in studying AED teratogenicity. The primary outcome of interest in these registries is the occurrence of major congenital malformations, with some data collected on minor malformations. Cognitive and behavioral outcomes are often beyond the timeframe for follow-up of these registries and require independent study. The HOPE consensus report describes the current state of knowledge and the limitations to interpretations of information from the various sources. Data regarding specific risks for both older and newer AEDs need to be analyzed carefully, considering study designs and confounding factors. There is a critical need for investigations to delineate the underlying mechanisms and explain the variance seen in outcomes across AEDs and within a single AED.

Original languageEnglish (US)
Pages (from-to)1109-1117
Number of pages9
JournalNeurology
Volume71
Issue number14
DOIs
StatePublished - Sep 30 2008

ASJC Scopus subject areas

  • Clinical Neurology

Fingerprint Dive into the research topics of 'Pregnancy registries in epilepsy: A consensus statement on health outcomes'. Together they form a unique fingerprint.

Cite this