The effectiveness of preconception counseling to reduce adverse pregnancy outcome in women with epilepsy: what's the evidence?
OBJECTIVE
The purpose of this Cochrane review was to determine the effectiveness of delivering preconception counseling interventions to women with epilepsy (WWE) as a means of reducing adverse pregnancy outcomes, increasing knowledge, and increasing intentions to plan pregnancy.


METHODS
Two hundred twenty-five citations were retrieved from a systematic search of the Cochrane Library and electronic databases: Medline (OVID), Scopus, CINAHL, PsychINFO, and ASSIA, and hand searches of relevant epilepsy and obstetric journals.


RESULTS
The search strategy identified 11 studies for consideration for inclusion. However, none met the required criteria for inclusion.


CONCLUSIONS
There is no robust evidence to inform the content, methods of delivery, or likely effectiveness of preconception counseling to improve pregnancy outcomes for WWE and their offspring. The value of counseling WWE prior to conception remains uncertain and requires evaluation in well-designed studies, appropriately powered to detect changes likely associated with both maternal and infant outcomes.
Winterbottom
Janine
J
Epilepsy Department, The Walton Centre for Neurology and Neurosurgery NHS Trust, Lower Lane, Fazakerley, Liverpool, UK. J.B.Winterbottom@liv.ac.uk
Smyth
Rebecca
R
Jacoby
Ann
A
Baker
Gus
G
D003376:Counseling; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D004827:Epilepsy / Q000628:therapy*; D005260:Female; D006801:Humans; D016742:Preconception Care; D011247:Pregnancy; D011256:Pregnancy Outcome; D016032:Randomized Controlled Trials as Topic