Many Women with Epilepsy Miss Essential Specialist Care During Pregnancy, Study Reveals

A recent study highlighting concerns in prenatal healthcare for women with epilepsy shows that only slightly more than half of these women consult a neurologist during pregnancy. This significant gap in specialist care raises concerns because it can lead to increased risks for both mother and child. The research, presented at the 150th Annual Meeting of the American Neurological Association, analyzed data from 2,385 women who delivered between 2016 and 2021. The findings revealed that 45% of women did not see a neurologist during the year prior to childbirth, potentially missing crucial guidance on managing epilepsy safely during pregnancy.

Clinical guidelines advocate for comprehensive strategies to mitigate pregnancy-related risks, including optimizing antiseizure medication (ASM) regimens and close monitoring of drug levels. Women who engaged with neurologists were significantly more likely to be prescribed recommended ASMs like lamotrigine, levetiracetam, and oxcarbazepine, and were less likely to discontinue medication before delivery. Conversely, those without specialist care often used less suitable medications, such as valproic acid, associated with higher risks of birth defects like spina bifida, cleft lip, and heart abnormalities, as well as neurodevelopmental issues.

Neurologists play a vital role in balancing seizure control and medication safety, ensuring expectant mothers receive personalized treatment plans that minimize risks. For example, they can advise on folic acid supplementation and the safest medication choices to reduce congenital defect risks while maintaining seizure control.

The study also found that women who saw a neurologist were more likely to continue recommended treatments, reducing the chance of uncontrolled seizures, placental abruption, low oxygen supply, preterm birth, or miscarriage. Despite the importance of this specialized care, only about 55% of women in the study sought neurologist consultation during pregnancy, indicating a systemic issue in healthcare access and coordination.

Overall, the research underscores the need for improved healthcare strategies to ensure women with epilepsy receive the necessary specialist care to promote healthier pregnancy outcomes and safeguard both maternal and fetal health.