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Pregnancy Considerations for Women With Epilepsy—The WEPOD Study


 

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VANCOUVER—Women with epilepsy seeking pregnancy had comparable likelihood of achieving pregnancy, time to achieve pregnancy, and pregnancy outcomes, compared with a group of healthy peers, according to study findings presented at the 68th Annual Meeting of the American Academy of Neurology. "These findings should reassure women with epilepsy and clinicians when counseling women with epilepsy who are planning pregnancy," said Page B. Pennell, MD, Associate Professor of Neurology at Brigham and Women's Hospital and Harvard Medical School in Boston, and her research colleagues.

Page B. Pennell, MD, Associate Professor of Neurology at Brigham and Women's Hospital and Harvard Medical School in Boston, and her research colleagues.

Page B. Pennell, MD

Previous studies suggested that women with epilepsy have lower fertility compared with healthy controls. Dr. Pennell and colleagues sought to compare time to pregnancy and outcomes (eg, live birth, miscarriage) among women with epilepsy and healthy controls. The Women with Epilepsy: Pregnancy Outcomes and Deliveries (WEPOD) study was a multicenter, prospective, observational study of women with epilepsy and healthy controls.

Dr. Pennell and colleagues enrolled and prospectively followed women with epilepsy and healthy controls, ages 18 to 41, seeking pregnancy within six months of discontinuing contraception. The customized WEPOD electronicdiary captured medication use, seizures, sexual activity, and menstrual bleeding. Pregnancy tests were performed if there was no menses by cycle day 35. Outcomes included proportions of women who achieved pregnancy and time to pregnancy from cessation of birth control. The researchers used a proportional hazard model to evaluate the association between time to pregnancy and certain baseline characteristics.

Enrolled in the study were 88 women with epilepsy and 109 healthy controls with similar demographic characteristics. Among women with epilepsy, 61.4% achieved pregnancy versus 60.6% for healthy controls. Median time to pregnancy was six months in women with epilepsy, compared with nine months for healthy controls. Time to pregnancy was no different across the two groups after controlling for age, BMI, parity, and race. Race and parity were significantly associated with time to pregnancy.

Of the pregnancies that occurred, a similar proportion resulted in miscarriage (12.9% among women with epilepsy and 19.7% among controls), live birth (80.0% among women with epilepsy and 80.3% controls) or other outcome (5.0% versus 0.0%).

The WEPOD study was supported by the Epilepsy Foundation.

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