Abstracts

RATIONALE: This presentation describes the initial experience with the prospective Irish Epilepsy and Pregnancy Register. This is part of a worldwide effort gathering prospective data to determine the safest strategies for the treatment of women with epilepsy who are pregnant or planning to become pregnant. The Irish Epilepsy and Pregnancy Register was initiated in May 2001, and has close links with the U.K. Register which is based in Belfast. Its main aims are: (1) to establish the relative safety of anti-convulsant drugs with reference to major malformations in the offspring of women with epilepsy, (2) to establish whether seizure frequency is related to adverse outcome in pregnancy, (3) to monitor the rate of pre-conceptual folic acid administration in women with epilepsy and whether this beneficially affects outcome, and (4) to educate people about epilepsy and pregnancy by giving pre-conceptual, pregnancy, and post-pregnancy advice.
METHODS: This is a prospective register of all women with epilepsy in Ireland who become pregnant. It is run by a research nurse and is based at the Clinical Research Centre at Beaumont Hospital in Dublin. All neurologists, general practioners and obstetricians in the country are informed of the register and are invited, following informed consent, to enroll their patients in the register. Relevant information is gathered in a systematic manner and stored on a database. Pregnancy outcome is determined at three months following the expected date of delivery.
RESULTS: To date, there are seventy-nine prospectively registered pregnancies with twenty-one full outcome reports to the Irish Epilepsy and Pregnancy Register. Thus far, there has been a wide exposure to a variety of anti-epileptic drugs in monotherapy, e.g. with carbamazepine, phenytoin, valproate, and lamotrigine. Various anti-epileptic drug combinations reported include treatment with the following drugs: carbamazepine, clonazepam, gabapentin, lamotrigine, levetiracetam, oxcarbazepine, phenobarbital, phenytoin, primidone, valproate and vigabatrin.
CONCLUSIONS: The Irish Epilepsy and Pregnancy Register is an ongoing long-term project. The register will continue to give advice to women with epilepsy who may or may not be taking anti-epileptic drugs, and will continue to enroll pregnant women with epilepsy. It is envisaged that the scope of the register will be widened to assess the cognitive and neuropsychological development of children born to mothers with epilepsy in Ireland.
[Supported by: The Irish Brain Research Foundation and the Monkstown Hospital Trust.]