Women with epilepsy just as likely to get pregnant as healthy women of childbearing age, new analysis shows

Women with epilepsy are just as likely to achieve a successful pregnancy as women without the neurological disorder, according to a new study led by research teams at multiple centers, including NYU Langone Medical Center.

In a prospective study, women with epilepsy were comparable regarding likelihood of achieving pregnancy, time taken to get pregnant, and pregnancy outcomes such as miscarriage, compared to a group of healthy peers. These findings, presented April 17 at the American Academy of Neurology’s 68th Annual Meeting in Vancouver, BC, contradict previously held beliefs in the medical community regarding the fertility of women with epilepsy.

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More than 1.1 million U.S. women with epilepsy are of childbearing age and approximately 24,000 babies are born to women with epilepsy each year, according to figures from The Epilepsy Foundation, which funded the new research.

Previous studies have found infertility rates up to two to three times higher for women with epilepsy, or that as many as one-third of women with epilepsy may experience difficulty with pregnancy. But, a comprehensive study has not been done to date to confirm this until now, according to the researchers.

“We hope our findings reassure women with epilepsy who are considering having children, and clinicians who are counseling these women on family planning,” says Jacqueline French, MD, professor of neurology and Director of Translational Research and Clinical Trials at NYU Langone’s Comprehensive Epilepsy Center, and the study’s first author and co-principal investigator.

The researchers led a multicenter observational study called The Women with Epilepsy: Pregnancy Outcomes and Deliveries (WEPOD) from 2010 to 2015. Women with epilepsy and healthy control participants who were between the ages of 18 and 41 seeking pregnancy and less than 6 months removed from contraception were followed throughout the duration of their pregnancy. Electronic diaries captured use of anti-epileptic medications, seizures, and facts about participants’ sexual activity and menstruation cycles.

In total, 89 women with epilepsy and 109 healthy controls with similar demographics were compared for the study. The proportion of women who achieved pregnancy was 70 percent for women with epilepsy and 67.1 percent for healthy controls.

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Average time to pregnancy in women with epilepsy was 6.03 months, compared with 9.05 months for healthy controls, and after controlling for age, body mass index, parity, and race, there was no difference across groups for time to pregnancy.

Of the pregnancies that occurred, a similar proportion resulted in live birth (81.8 percent women with epilepsy and 80 percent controls), miscarriage (12.7 percent women with epilepsy and 20 percent controls), or other outcomes (5.4 percent women with epilepsy compared to 0 percent healthy controls).

In addition to French, the other principal investigators in this multicenter study were Page Pennell, MD, professor of neurology at Harvard Medical School and Director of Research for Brigham and Women’s Hospital’s Epilepsy Program, and Cynthia Harden, MD, System Director of Epilepsy Services at the Mount Sinai Health System and professor of neurology, Icahn School of Medicine at Mount Sinai in New York.

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NYU Langone Medical Center   press release

American Academy of Neurology   68th Annual Meeting - 2016