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Epilepsy does not affect chance of pregnancy, or outcomes

Similar likelihood of conception, time to pregnancy, and live birth rates as those without epilepsy

Louise Prime

Wednesday, 02 May 2018

Women with epilepsy who wanted to conceive and who had no prior known infertility or related disorders had a similar likelihood of achieving pregnancy, time to pregnancy, and live birth rates compared with their peers who did not have epilepsy, research has shown. The authors of the study*, published in JAMA Neurology, said their results should reassure women with epilepsy (WWE) with no prior diagnosis of infertility or related disorders, as well as their doctors, when planning pregnancy.

A US team of researchers said that although previous research has suggested lower birth rates for women with epilepsy, it has not differentiated between the biological and social factors that might contribute. And they cited a UK survey from 2003 that found that 33% of WWE respondents were not considering having children because of their epilepsy.

So they set out to investigate whether WWE without a prior diagnosis of infertility or related disorders have the same likelihood of achieving pregnancy within 12 months as their peers without epilepsy. They also considered secondary outcomes: time to pregnancy using a proportional hazard model, pregnancy outcomes, sexual activity, ovulatory rates, and analysis of epilepsy factors in WWE.

They enrolled non-smoking women aged 18-40 years (mean 31.9 years), who were seeking pregnancy and were within six months of stopping contraception, into the Women With Epilepsy: Pregnancy Outcomes and Deliveries study. Participants included 89 WWE and 108 control women (CW), whom they followed for 21 months.

Among the 197 women in the study, 54 (60.7%) of WWE achieved pregnancy compared with 65 (60.2%) of controls. Median time to pregnancy was not significantly different between the groups after controlling for key covariates (6.0 months in WWE and 9.0 months in CW). Sexual activity and ovulatory rates were similar in WWE and CW. Live births resulted from 44 of the 54 pregnancies (81.5%) in WWE and 53 of the 65 pregnancies (81.5%) in CW. The study authors also found no difference in pregnancy outcomes between women who had had seizures within the prior nine months and seizure-free women.

They concluded: “In this prospective cohort study of women without an a prior diagnosis of infertility or related disorder, WWE seeking pregnancy experienced similar pregnancy rates compared with their peers without epilepsy. Secondary analyses also showed similar times to achieve pregnancy and pregnancy outcomes.

“Although this study design cannot exclude an increased risk for impaired fertility across all WWE, our results should reassure WWE without a prior diagnosis of infertility or related disorders and the clinicians who care for them when planning pregnancy.”

*Pennell PB, French JA, Harden CL, et al. Fertility and birth outcomes in women with epilepsy seeking pregnancy. JAMA Neurol. Published online April 30, 2018. doi:10.1001/jamaneurol.2018.0646

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