Maintaining seizure freedom during pregnancy and postpartum: Findings from the MONEAD Study

The American Academy of Neurology (AAN) 70th Annual MeetingP Pennell, J French, R May, E Gerard, L Kalayjian, E Gedzelman, P Penovich, J Cavitt, S Hwand, A Pack, M Sam, E Moore, D Ippolito, K Meador | April 23, 2018

Advertisement

Summary: In the NIH-funded, prospective, observational, multi-center Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD) study, researchers analyzed the likelihood of women with epilepsy to remain seizure-free during pregnancy and postpartum compared with non-pregnant women with epilepsy (NPWWE).  Theirs is the first study to compare seizure frequency changes in pregnant women with epilepsy (PWWE) to NPWWE. They found a low risk of seizure recurrence during pregnancy for women who were seizure-free prior to conception, not different from that seen in women who were not pregnant.

Methods:

  • Researchers enrolled 351 PWWE and 109 NPWWE to maintain group balance with PWWE on age, race, ethnicity, baseline seizure frequency and AED regimen.
  • They included the number of seizures prior to enrollment but after conception through day of delivery in the pregnancy seizure rates of PWWE.

Results:

  • In the PWWE group, researchers found that 46.7% were seizure-free for the 9 months preceding pregnancy, compared with 45.0% of NPWWE who were seizure-free for the 9 months prior to enrollment.
  • Among women who were seizure-free at baseline, 84.8% of PWWE remained seizure-free during pregnancy and 87.8% during the 9 months postpartum; 85.7% of NPWWE remained seizure-free for 9 months following enrollment, and 83.7% in the subsequent 9 months.

This study was supported by the National Institutes of Health, NINDS and NICHD.

Advertisement