Abstracts

Rationale: Antiepileptic drugs (AED) are common teratogenic drugs prescribed to women of childbearing age. AED can induce both anatomical and behavioral teratogenicity; its risk is markedly increased by the use of Valproic Acid (VPA). On the other hand, the benefit of preventing seizures by AED treatment during pregnancy is still controversial. Methods: Our primary goal was to observe and AED treatment policy regarding a relatively long period: We investigated all cases of female epileptic patients admitted for labor at the Rabin Medical Center, Petah Tikva, Israel, from 2005 to 2015.297 deliveries were recorded in 235 women with known epilepsy. 135 labors occurred in 2005-2010 (27/y) and 162 in 2011-2015 (32.4/y; increase of 20%). The percentage of women experiencing seizures during pregnancy was 23.3 % and unchanged during the observed period (2005-2010: 22.9% vs. 2011-2015: 23.0%; p=0.92). A trend for decreased seizures at delivery was observed (13.3% vs. 10.5%) but not significant (p>0.05).  Results: Our cohort was treated with ten different AED. Lamotrigine (LTG) and Carbamazepine (CBZ) were the most commonly used (35% and 36% respectively; total: 60.9%). Their use did not change over the examined period (LTG: 35% vs 36.4%; CBZ: 24% vs 26%; p>0.05). The use of VPA for pregnant women with epilepsy was less compared to LTG or CBZ (13.5% vs. 60.9%) and its use decreased dramatically by 50% regarding the two time episodes observed (18% versus 9.3%; p=0.04). However, the percentage of women with combination of several AED increased from 10.4% to 13.6%.  Conclusions: We detected a general increase of pregnancies in epileptic patients during 2005-2015. There is a tendency for a reduction in seizure frequency on delivery without difference of seizures quantity during pregnancy. We can confirm a marked 50% decline in the use of VPA but with 20% elevation of AED combination use. Funding: No funding.