Abstracts

Rationale: Epilepsy is one of the most common neurological disorders in pregnancy, with a prevalence of 0·3–0·7%. Pregnancy in women with epilepsy (WWE) represents a particular challenge, as the need for seizure control must be balanced with potential adverse effects of antiseizure medications (ASM) on the developing fetus. Uncontrolled seizures during pregnancy can lead to maternal complications such as injury, placental abruption, and even maternal mortality. It is crucial to educate women with epilepsy at childbearing age about importance of epilepsy care during the pregnancy, optimize seizure control before pregnancy, avoid unplanned pregnancies, switch the antiseizure medications to those with less teratogenic effect. These can better be achieved by having dedicated epilepsy clinic for WWE during pregnancy, with trained staff and stablished communication with maternal fetal medicine specialist. This study aims to assess whether having a dedicated clinic for pregnant WWE, can improve the outcome of pregnancy in epileptic patients when compared to patients seen outside of a dedicated clinic.


Methods: this is a retrospective chart review of all WWE who delivered between January 1^st, 2017 and April 30^th 2024 and received epilepsy care at the University of Illinois at Chicago (UIC) Hospital. Inclusion criteria: Epilepsy diagnosis, age 15-45 yo. Information regarding demographics, epilepsy history, ASMs, seizure control during pregnancy, pregnancy data, and pregnancy outcomes were collected. Chi-square and Fisher’s exact tests were used to estimate associations between categorical variables as appropriate.

A password-protected, HIPPA compliant data entry system, RedCap (Research Electronic Data Capture) was built for data collection.


Results: we had a total of 67 patients with epilepsy who were pregnant in the study period. Group 1 is the group without established WWE clinic and Group 2 is the group with established WWE clinic. 35.7% of all patients were Hispanic. 71.4% had medicare/Medicaid insurance. 57.1 % were diagnosed with Focal Epilepsy and 15.7 % were unknown. More patients were referred to epilepsy clinic < 8 weeks pregnancy for group 2 compared to group 1 (32.8% vs 26.8 %). Patient in group one had higher seizure frequency during pregnancy compared to group 2 ( p< 0.05). More patients in group 1 were taking topiramate than group 2 (p=0.07).

Conclusions: Establishing a dedicated clinic for WWE improves outcomes by significantly reducing seizures during pregnancy, primarily because patients receive better education and personalized care tailored to managing their condition.

Funding: none