title: The outcomes of pregnancy in women with untreated epilepsy.
abstract: OBJECTIVE
  To determine the outcomes in regards to seizure control and foetal malformation in pregnant women with epilepsy not treated with antiepileptic drugs (AEDs).
  
  
  METHODS
  Analysis of data from the Australian Register of AEDs in Pregnancy on 148 women with epilepsy who were not receiving AEDs before and during at least the first trimester of pregnancy.
  
  
  RESULTS
  Seizure control was less likely to be maintained in AED-untreated pregnancies. Whether AED therapy had been ceased in preparation for pregnancy, or had not been employed for long periods before pregnancy, made no statistically significant difference to seizure control outcomes, but those who ceased therapy in preparation for pregnancy were more likely to again be taking AED therapy by term. Foetal malformation rates were reasonably similar in untreated pregnancies, and in treated pregnancies if pregnancies exposed to known AED teratogens (valproate and probably topiramate) were excluded from consideration.
  
  
  CONCLUSIONS
  Leaving epilepsy untreated during pregnancy appears disadvantageous from the standpoint of seizure control: it also does not reduce the hazard of foetal malformation unless it avoids valproate or topiramate intake during pregnancy.
authors.affiliation: Department of Medicine and Neurosciences, Royal Melbourne Hospital and University of Melbourne, Parkville, Victoria 3050, Australia. Electronic address: vajda@netspace.net.au.
authors.forename: F J E
authors.initials: FJ
authors.lastname: Vajda
authors.affiliation: Department of Medicine and Neurosciences, Royal Melbourne Hospital and University of Melbourne, Parkville, Victoria 3050, Australia.
authors.forename: T J
authors.initials: TJ
authors.lastname: O'Brien
authors.affiliation: Department of Medicine and Neurosciences, Royal Melbourne Hospital and University of Melbourne, Parkville, Victoria 3050, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Graham
authors.affiliation: Royal Brisbane and Women's Hospital and School of Medicine and Biomedical Science, University of Queensland, Brisbane, Queensland 4027, Australia.
authors.forename: C M
authors.initials: CM
authors.lastname: Lander
authors.affiliation: Royal Brisbane and Women's Hospital and School of Medicine and Biomedical Science, University of Queensland, Brisbane, Queensland 4027, Australia.
authors.forename: M J
authors.initials: MJ
authors.lastname: Eadie
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D001315:Australia; D004827:Epilepsy / Q000188:drug therapy; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D012042:Registries; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants
keywords: Antiepileptic drugs; Epilepsy; Foetal malformations; Pregnancy; Seizures