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 epilep...

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Bibliographic Details
Published in:Epilepsia (Copenhagen) 2009-05, Vol.50 (5), p.1229-1236
Main Authors: HARDEN, Cynthia L, HOPP, Jennifer, 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, TING, TriciaY, LE GUEN, Claire, PENNELL, Page B, FRENCH, Jacqueline A, HAUSER, W. Allen, WIEBE, Samuel, GRONSETH, Gary S, THURMAN, David, MEADOR, Kimford J
Format: Article
Language:English
Subjects:
Abortion, Spontaneous - epidemiology
Anticonvulsants - therapeutic use
Anticonvulsants. Antiepileptics. Antiparkinson agents
Biological and medical sciences
Cesarean Section
Epilepsy - drug therapy
Epilepsy - epidemiology
Female
Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy
Humans
Hypertension - epidemiology
Medical sciences
Nervous system (semeiology, syndromes)
Neurology
Neuropharmacology
Obstetric Labor, Premature - epidemiology
Odds Ratio
Pharmacology. Drug treatments
Pre-Eclampsia - epidemiology
Pregnancy
Pregnancy Complications - drug therapy
Pregnancy Complications - epidemiology
Recurrence
Risk
Smoking - epidemiology
Status Epilepticus - drug therapy
Status Epilepticus - epidemiology
Uterine Hemorrhage - epidemiology
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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.
ISSN:0013-9580
1528-1167
DOI:10.1111/j.1528-1167.2009.02128.x