Epilepsy Necessitates Careful Pregnancy Planning

Because some antiepileptic drugs (AEDs) are teratogenic, women with epilepsy who desire pregnancy are advised to take folate supplements and use the smallest effective doses of the fewest possible AEDs prior to conceiving. However, many pregnancies in women with epilepsy are unplanned. To examine rates of spontaneous fetal loss when pregnancy was planned or unplanned, researchers analyzed data from 1144 women with epilepsy (age range, 18–47) who completed an online survey between 2010 and 2014.

Rates of spontaneous fetal loss were considerably lower among planned than unplanned pregnancies (16% vs. 35%; P<0.001). Among planned pregnancies, 84% resulted in a live birth. Rates of spontaneous fetal loss did not differ significantly by type of A…