EPILEPSY IN PREGNANCY

Approximately 25% of people with epilepsy are women of childbearing age.

Research funded by Epilepsy Research UK has led to changes in policy and clinical practice relating to epilepsy medication for use during pregnancy.

Early career support from Epilepsy Research UK helped Dr Rebecca Bromley establish herself as an expert in her field, enabling her to influence guidance on prescription medicine for women with epilepsy.

EPILEPSY MEDICATION DURING PREGNANCY

Exposure of a baby to certain prescribed medications in the womb can cause birth defects and negatively impact brain development, leading to poor cognitive and social outcomes for the child. Over the past decade, researcher Dr Rebecca Bromley and colleagues have investigated the effect of taking antiepileptic drugs during pregnancy on children’s health.

INVESTIGATING OUTCOMES IN CHILDREN EXPOSED TO VARIOUS MEDICATIONS

After receiving her PhD in 2009, early career support from Epilepsy Research UK enabled Dr Bromley to further extend her earlier research to investigate outcomes in children exposed to various types of antiepileptic medications and this work formed part of her doctorate in clinical psychology.

Following completion of her Clinical Psychology training she secured a prestigious National Institute of Health Research postdoctoral fellowship in 2013 and gained further support from Epilepsy Research UK. This was to undertake research with Dr Rachel Charlton at the University of Bath, investigating the optimal methods to assess child development within the context of medication exposure.

NEW GUIDANCE

Dr Bromley quickly became a leader in her field and her work formed part of a growing body of research showing that foetal exposure to the antiepileptic drug sodium valproate can pose a substantial risk to development. Research has now shown that if sodium valproate is taken during pregnancy, up to 4 in 10 babies are at risk of developmental disorders and roughly 1 in 10 are at risk of birth defects. Over the past five years Dr Bromley has given evidence about these risks to various government and regulatory bodies including the European Medicines Agency (EMA) reviews in 2014 and 2017.

Following recommendations from the EMA after the evidence presented by Dr Bromley and other experts in the field, the MHRA issued new guidance on sodium valproate prescriptions in 2018. The guidance states that sodium valproate can no longer be prescribed to women of childbearing age unless they are on a pregnancy prevention plan (PPP). This new regulation will be key to preventing unnecessary risk to babies of women with epilepsy and other conditions for which this drug is prescribed, like bipolar disorder and migraines.

Dr Bromley continues working on these issues and in 2017 obtained further Epilepsy Research UK funding to investigate the potential relationship between exposure to seizures in the womb and later child outcomes. She is also now working as part of the EU funded ConcePTION study which aims to improve current systems through which the potential impacts associated with medication use in pregnancy and/or breastfeeding are investigated and disseminated to both patients and healthcare professionals.

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Accelerating innovations for people with epilepsy by supporting research that will influence clinical practice and health policy

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