[Epilepsy and pregnancy--drug use, seizure control, and complications].

BACKGROUND

There is insufficient knowledge about the effect of epilepsy and epilepsy treatment on pregnancy, and vice versa. The European Registry of Antiepileptic drugs and Pregnancy (EURAP) was therefore established in 1999. We here present the results from the Norwegian part of the study, with emphasis on attack control, use of antiepileptics and folate, presence of status epilepticus, attacks in connection with birth and complications in the pregnancy.

MATERIAL AND METHOD

The study is prospective and observational. The women are offered 5 consultations, 3 during pregnancy and 2 after birth.

RESULTS

As of September 2005, 296 pregnancies in 263 Norwegian women were included. In 220 pregnancies (74 %), the women were treated with a single antiepileptic drug, most often carbamazepine. In 187 pregnancies (63 %), the women were seizure free. In those with seizures, 17 % had an increase in seizure frequency during pregnancy and 15 % had a decrease. Convulsive status epilepticus associated with delivery occurred in 1 % of the women and seizures associated with the delivery in 2.7 %. The consequences for the mother and the child were not as serious as previously reported. The frequency of complications during pregnancy and the sectio rate did not differ significantly from the average population.

INTERPRETATION

Most women with epilepsy go through pregnancy and delivery without complications. Specialists should only follow up those with a suboptimal seizure control. The slightly increased teratogenic risk can be reduced by giving these women extra folate before the conception.