Antiseizure Medication Use and Folic Acid Supplementation in People with Epilepsy of Childbearing Potential

Updated guidelines based on evidence through 2022 offer new recommendations on use of folic acid supplementation to improve neurodevelopment outcomes in offspring and preferred antiseizure medications with the lowest rates of major congenital malformations.

Sponsoring Organizations: American Academy of Neurology, American Epilepsy Society, and the Society for Maternal-Fetal Medicine

Background and Objective

Prior 2009 guidelines on caring for people with epilepsy of childbearing potential (PWECP) emphasized the higher risk for major congenital malformations (MCM) and adverse cognitive outcomes in the offspring of PWECP after in utero valproic acid (VPA) exposure relative to other first-generation antiseizure medications (ASMs). Similar guidelines suggested that folic acid supplementation may reduce risk for MCMs.

Key Points

To address the prevalence of outcomes associated with intrauterine exposure to newer ASMs and folic acid in PWECP, this systematic review identified a total of 82 articles, of …

Reviewing Author

Tanya J.W. McDonald, MD, PhD

Disclosures

Grant/Research SupportAmerican Epilepsy Society; American Heart Association

Tanya J.W. McDonald, MD, PhD

Disclosures

Grant/Research SupportAmerican Epilepsy Society; American Heart Association

Antiseizure Medication Use and Folic Acid Supplementation in People with Epilepsy of Childbearing Potential

Topics

Background and Objective

Key Points

Reviewing Author