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Study underlines importance of seeking specialist epilepsy advice for pregnant women

A recent report has confirmed that women of childbearing age should seek the advice of an epilepsy specialist when planning a family or when pregnant.

During pregnancy and childbirth a woman's epilepsy - particularly her seizure control -can change, sometimes requiring alterations to medication and dosage.

The study from the Harvard T.H. Chan School of Public Health surveyed women with and without epilepsy who had been discharged from American hospitals.  Researchers found that women with epilepsy were at a 10-fold increased risk of mortality during delivery in a hospital in comparison to women without epilepsy. In the UK the risk of a woman dying during pregnancy is one in 6,900.

Pregnant women with epilepsy also faced an increased risk for other pregnancy complications, such as preeclampsia, preterm labour, and still birth.

However, lead author Dr. Thomas F. McElrath stressed that death during pregnancy for women with epilepsy is exceedingly rare and that pregnancy was now 'quite safe'.

He said pregnant women who have been diagnosed with epilepsy should not be scared. These women are simply a “category of patients, like patients with diabetes or patients with asthma,” he said.

Dr Jacqueline A. French, author of Risks of Epilepsy During Pregnancy: How Much Do We Really Know, was asked by JAMA Neurology to share her thoughts on the study’s findings.  She found that, while most women with epilepsy have uncomplicated pregnancies, this study correlates with others before it. Although, she noted, this study sets itself apart by finding mortality doesn’t occur during delivery, but outside delivery.

Dr French said deaths were related to poor seizure control, which might indicate women who are well-controlled during their pregnancy lower their risk of complication.

Women with epilepsy who are thinking of starting a family or who are already pregnant should seek pre-conceptual counselling to ensure seizure-control during pregnancy and after delivery.