Findings from a long-term observational study of women with epilepsy trying to get pregnant and age-matched healthy controls found that there are no differences in the time it takes to conceive a child and carry that child to term.
The data, based on an analysis from the Women with Epilepsy: Pregnancy Outcomes and Deliveries (WEPOD) study, were presented here on Sunday at the AAN Annual Meeting.
“The study runs counter to older ones that did find women with epilepsy were at risk for miscarriage, infertility, and lower chances of carrying a pregnancy to term,” said the lead study author Jacqueline A, French, MD, FAAN, director of translational research and clinical trials in epilepsy at the New York University Langone Medical Center, who collaborated with Cynthia L. Harden, MD, director of North Shore-LIJ’s Comprehensive Epilepsy Care Center, and Page Pennell, MD, director of research for the division of epilepsy at the Brigham and Women’s Hospital. But she noted that the investigators wanted to look at the issue again with the newer generation of antiepileptic drugs.
“We felt that it was important to look at these issues prospectively,” said Dr. French. “This is good news for our patients who are thinking about starting families.”
They asked their study cohort — 88 women with epilepsy and 109 controls —questions about pregnancy and their menstrual cycle during their childbearing years. They were also asked to keep a daily electronic diary of information that included the medication they took, when they got their menstrual period, whether they had a seizure, and whether they engaged in sex.
Among the findings, the results showed that was an almost equivalent rate of pregnancies — 61.4 percent in the epilepsy group and 60.6 percent in the healthy controls. The miscarriage rate was not significantly different either: 12.9 percent in the epilepsy group compared with 19.7 percent in the controls.
They also assessed time to pregnancy from cessation of birth control and reported no differences after controlling for age, BMI, parity, and race. The proportion of lives births was also identical — 80.0 percent in the women with epilepsy and 80.3 percent in the controls.
“It is reassuring,” said Dr. French. “These are the questions we are asked all the time by our patients. I am glad we will finally be able to answer these questions.”
Commenting on the study, Alison Pack, MD, MPH, associate professor of neurology at Columbia University Medical Center, said the findings will be “important in helping doctors taking care of epilepsy patients who want to have families.”
She said that the older studies have found decreased fertility in patients compared with healthy women, but the studied populations were not identically matched. In addition, earlier studies have typically included women treated with older medications such as phenobarbital that have been associated with reduced conception and other problems.
Kimford J. Meador, MD, FAAN, professor of neurology and neurological sciences at Stanford University School of Medicine, added: “This is another piece of data that should help in counseling women with epilepsy,” he said. “This will definitely change the talk. We can now say that there is not an increased risk of infertility issues.”
