Seizure frequency not up in pregnancy for women with epilepsy

Among women with epilepsy, the percentage who have a higher incidence of seizures during pregnancy than in the postpartum period is similar to that seen during corresponding epochs in women who are not pregnant, according to a study published in the Dec. 24 issue of the New England Journal of Medicine.

Page B. Pennell, M.D., from Brigham and Women’s Hospital in Boston, and colleagues conducted an observational multicenter cohort study to compare the frequency of seizures during pregnancy through the peripartum period (the first six weeks after birth; epoch 1) to the frequency during the postpartum period (the following 7.5 months; epoch 2). Nonpregnant women with epilepsy were enrolled as controls and followed up during 18 months. A total of 351 pregnant women and 109 controls with epilepsy were enrolled.

Among women who had a history of seizures that impaired awareness and had data available for both epochs, the researchers found that seizure frequency was higher during epoch 1 than epoch 2 in 70 pregnant women (23 percent) and 23 controls (25 percent; odds ratio, 0.93; 95 percent confidence interval, 0.54 to 1.60). The dose of an antiepileptic drug was changed at least once during pregnancy in 74 percent of pregnant women and in 31 percent of controls (odds ratio, 6.36; 95 percent confidence interval, 3.82 to 10.59).

“There was no meaningful difference between pregnant women and nonpregnant women in increased seizure frequency during epoch 1 as compared with epoch 2,” the authors write.

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