Abstracts

To study the outcomes of pregnancy in women with epilepsy taking antiepileptic drugs (AEDs) compared with women untreated or those taking AEDs for non-epileptic indications, in relation to effects on the foetus and on seizure control. Nationwide voluntary observational study enrolling women prospectively or retrospectively after informed consent. There have been 754 women enrolled, 85% enrolled prospectively, with 662 birth outcomes comprising 581 live normal births, 44 babies with defects (BD) (10 detected within first year after birth), 8 induced abortions with defects, 21 spontaneous abortions, 7 stillbirths, 1 abortion for maternal indications and 8 lost to follow-up. The incidence of BDs not exposed to medication was 3.6%, on valproate (VPA) combined monotherapy and polytherapy was 13%, on phenytoin was 4.7%, carbamazepine was 4.5%, on lamotrigine monotherapy was 5.6%, on lamotrigine polytherapy 5%. Partial epilepsy was the major reason for AED use (318 v.292 generalised epilepsy). Earlier findings of high risk of BD on VPA monotherapy above doses of 1100 mg per day were confirmed. Prescriptions for VPA and doses of VPA had fallen progressively over the last three years while both have increased for lamotrigine. Changing prescribing trends, with a fall in VPA doses, and comparable risks of BDs related to other AEDs are the major findings. The Registry is a significant resource in women[apos]s health issues.