Do women with epilepsy benefit from epilepsy specific pre-conception care?

Area of Science:

• Neurology
• Obstetrics & Gynecology
• Public Health

Background:

• Epilepsy in pregnancy presents risks for both mother and fetus.
• Pre-conception care (PCC) aims to optimize health before pregnancy.
• Understanding PCC's impact on women with epilepsy (WWE) is crucial for improving outcomes.

Purpose of the Study:

• To evaluate how pre-conception care (PCC) influences pregnancy outcomes in women with epilepsy (WWE).
• To assess the effect of PCC on seizure control and malformation risk in WWE.
• To compare outcomes between women receiving PCC and those receiving care in the first trimester.

Main Methods:

• Prospective enrollment of primigravida women with epilepsy into either a PCC group or a first-trimester pregnancy (PRG) group.
• Comparison of fetal and maternal outcomes, including seizure control and pregnancy complications.
• Analysis of demographic data, antiepileptic drug (AED) use, folate supplementation, and malformation rates.

Main Results:

• The PCC group showed significantly higher education, employment, and folate usage.
• Women in the PCC group were more likely to be seizure-free during pregnancy (62.8%) compared to the PRG group.
• No significant difference in the rate of fetal malformations was observed between the PCC (7.2%) and PRG (6.1%) groups.

Conclusions:

• Pre-conception care (PCC) is associated with reduced seizure risk during pregnancy for women with epilepsy.
• PCC improves periconceptional folate use, a key factor in preventing birth defects.
• PCC does not appear to influence the risk of fetal malformations in this cohort.