Changes in Seizure Frequency and Antiepileptic Therapy during Pregnancy

This prospective, multicenter cohort study compared seizure frequency and antiepileptic drug (AED) adjustments in 351 pregnant women and 109 nonpregnant controls with epilepsy. The primary outcome higher seizure frequency during pregnancy and peripartum (epoch 1) versus postpartum (epoch 2) occurred in 23% of pregnant women and 25% of controls (OR, 0.93; 95% CI, 0.54–1.60), indicating no significant difference. However, 74% of pregnant women required AED dose changes versus 31% of controls (OR, 6.36; 95% CI, 3.82–10.59). The study highlights that pregnancy itself did not increase seizure risk but necessitated more frequent AED adjustments, likely due to altered pharmacokinetics.

This prospective, multicenter cohort study compared seizure frequency and antiepileptic drug (AED) adjustments in 351 pregnant women and 109 nonpregnant controls with epilepsy. The primary outcome higher seizure frequency during pregnancy and peripartum (epoch 1) versus postpartum (epoch 2) occurred in 23% of pregnant women and 25% of controls (OR, 0.93; 95% CI, 0.54–1.60), indicating no significant difference. However, 74% of pregnant women required AED dose changes versus 31% of controls (OR, 6.36; 95% CI, 3.82–10.59). The study highlights that pregnancy itself did not increase seizure risk but necessitated more frequent AED adjustments, likely due to altered pharmacokinetics.