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Management issues for women with epilepsy—Focus on pregnancy (an evidence‐based review): I. Obstetrical complications and change in seizure frequency
Author(s) -
Harden Cynthia L.,
Hopp Jennifer,
Ting Tricia Y.,
Pennell Page B.,
French Jacqueline A.,
Allen Hauser W.,
Wiebe Samuel,
Gronseth Gary S.,
Thurman David,
Meador Kimford J.,
Koppel Barbara S.,
Kaplan Peter W.,
Robinson Julian N.,
Gidal Barry,
Hovinga Collin A.,
Wilner Andrew N.,
Vazquez Blanca,
Holmes Lewis,
Krumholz Allan,
Finnell Richard,
Le Guen Claire
Publication year - 2009
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/j.1528-1167.2009.02128.x
Subject(s) - pregnancy , medicine , epilepsy , obstetrics , premature birth , pediatrics , gestation , psychiatry , genetics , biology
Summary 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.