Maintaining seizure freedom during pregnancy and postpartum: findings from the MONEAD study.
The Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD) study is a National Institutes of Health-funded, prospective investigation of outcomes for mother and child. The study enrolled 351 pregnant women with epilepsy who participated in MONEAD and 109 nonpregnant women with epilepsy. Baseline seizure frequency and antiepileptic drug regimen were observed.
For 9 months prior to conception, 164 of 351 (46.7%) pregnant women with epilepsy were seizure free compared with 45% of the nonpregnant women with epilepsy. Of the participants who were seizure free, 84.8% of pregnant women with epilepsy remained seizure free during pregnancy and 87.8% were seizure free during 9 months postpartum.
In the nonpregnant women with epilepsy group, 85.7% remained seizure free for the 9 months after enrollment, and 83.7% remained seizure free during the subsequent 9 months.
The findings suggest that women who are seizure free prior to conception have a low risk for seizure recurrence during or after pregnancy. “Future analyses will include seizure frequency changes in all [women with epilepsy], with analysis of potential risk factors, including type and dosing of [antiepileptic drugs], seizure types, time to last seizure, and specific time windows,” concluded the researchers.