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.
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.
Harden
Cynthia L
CL
University of Miami, Miami, Florida, USA.
Hopp
Jennifer
J
Ting
Tricia Y
TY
Pennell
Page B
PB
French
Jacqueline A
JA
Allen Hauser
W
W
Wiebe
Samuel
S
Gronseth
Gary S
GS
Thurman
David
D
Meador
Kimford J
KJ
Koppel
Barbara S
BS
Kaplan
Peter W
PW
Robinson
Julian N
JN
Gidal
Barry
B
Hovinga
Collin A
CA
Wilner
Andrew N
AN
Vazquez
Blanca
B
Holmes
Lewis
L
Krumholz
Allan
A
Finnell
Richard
R
Le Guen
Claire
C
D000022:Abortion, Spontaneous / Q000453:epidemiology; D000927:Anticonvulsants / Q000627:therapeutic use; D002585:Cesarean Section; D004827:Epilepsy / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007752:Obstetric Labor, Premature / Q000453:epidemiology; D016017:Odds Ratio; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy / Q000453:epidemiology*; D012008:Recurrence; D012306:Risk; D012907:Smoking / Q000453:epidemiology; D013226:Status Epilepticus / Q000188:drug therapy / Q000453:epidemiology; D014592:Uterine Hemorrhage / Q000453:epidemiology
D000927:Anticonvulsants