Leaving epilepsy untreated during pregnancy ‘can be dangerous’

A new study from Australia has underlined the potentially significant health repercussions of leaving epilepsy untreated during pregnancy.

Scientists from the Royal Melbourne Hospital and University of Melbourne have analysed data on 148 women with epilepsy in order to find out more about seizure control and foetal malformation outcomes in expectant mothers with epilepsy who were not being treated with antiepileptic drugs (AEDs).

None of the patients involved in the trial were receiving AEDs before or during at least the first trimester of pregnancy. Results published in the medical journal Seizure demonstrated that this lack of treatment led to negative outcomes for mother and child alike.

It was shown that seizure control was less likely to be maintained in pregnant women who were not being medicated for their epilepsy, regardless of whether AED therapy had been ceased in preparation for childbearing, or had not been employed for long periods before pregnancy.

However, those who stopped therapy in preparation for pregnancy were shown to be more likely to have resumed AED therapy by term.

Other findings from the study included foetal malformation rates that were reasonably similar in treated and untreated pregnancies, provided that patients exposed to known AED teratogens – such as valproate and topiramate – were excluded from consideration.

The researchers concluded: “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.”

Pregnancy can affect epilepsy patients in a number of different ways. Some women are unaffected and others see improvements in their condition, but many find their seizures becoming more common and severe as a result of the physical and emotional stress that pregnancy can cause.

AEDs are a common method of treating such symptoms, but it is known that some therapies can increase the risk of physical defects in the developing baby, so it is common for expectant mothers to change their treatment approach during pregnancy.

However, this must not be done without specialist advice, making it crucial for pregnant women with epilepsy to consult an obstetrician or neurologist for guidance.

Posted by Anne Brown

Publication abstract: http://www.sciencedirect.com/science/article/pii/S1059131114002362

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