Abstracts

Rationale: New information concerning the risk of specific antiepileptic drugs (AEDs) on pregnancy outcomes has recently become available, which may affect prescription practices. We surveyed tertiary epilepsy centers in the USA to determine their current use of AEDs in women with epilepsy who are of child bearing potential and who are presently pregnant.Methods: The NEAD Study is an ongoing prospective multicenter observational investigation, which has enrolled pregnant women with epilepsy taking monotherapy carbamazepine (CBZ), lamotrigine(LTG), phenytoin (PHT), or valproate (VPA). These four AEDs were chosen because they were the most commonly used AEDs in the participating tertiary epilepsy centers during enrollment from 2000 to 2004. We surveyed 11 of our USA tertiary epilepsy centers over 6 months (2006-7).Results: Our survey found a total of 587 women of child bearing potential of which 3% were taking no AED, 54% monotherapy, and 43% polytherapy (majority 2 AEDs). AEDs in the monotherapy group (n=318) included LTG (33%), CBZ (14%), levetiracetam (LEV) (13%), topiramate (TPM) (8%), PHT (8%), zonisamide (ZNS) (7%), VPA (6%) and other (11%). There were 56 pregnant women of whom 14% were taking no AED, 75% monotherapy, and 11% polytherapy. Monotherapy (n=42) in pregnant women included TPM (24%), CBZ (19%), LTG (19%), LEV (12%), ZNS (10%), PHT (10%), oxcarbazepine (OXC) (4%), and VPA (2%).Conclusions: AED use in women of child bearing potential has changed in tertiary centers and will likely continue to shift as new information is added to our presently incomplete evidence base. Additional studies are needed to monitor this change and determine AED use for women in non-tertiary care centers.