Approved by the Quality Standards Subcommittee on November 5, 2008; by the Therapeutics and Technology Assessment Subcommittee on November 15, 2008; by the Practice Committee on December 18, 2008; and by the AAN Board of Directors on March 25, 2009.
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
Version of Record online: 27 APR 2009
Wiley Periodicals, Inc. © 2009 International League Against Epilepsy
Volume 50, Issue 5, pages 1229–1236, May 2009
How to Cite
Harden, C. L., Hopp, J., Ting, T. Y., Pennell, P. B., French, J. A., Allen Hauser, W., Wiebe, S., Gronseth, G. S., Thurman, D., Meador, K. J., Koppel, B. S., Kaplan, P. W., Robinson, J. N., Gidal, B., Hovinga, C. A., Wilner, A. N., Vazquez, B., Holmes, L., Krumholz, A., Finnell, R. and Le Guen, C. (2009), Management issues for women with epilepsy—Focus on pregnancy (an evidence-based review): I. Obstetrical complications and change in seizure frequency. Epilepsia, 50: 1229–1236. doi: 10.1111/j.1528-1167.2009.02128.x
This article is being published jointly/simultaneously by ILAE in Epilepsia and AAN in Neurology.
- Issue online: 7 MAY 2009
- Version of Record online: 27 APR 2009
- Accepted February 24, 2009; Early View publication April 27, 2009.
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.