Abstract Details

Title Is Pre-conceptional counselling for Women with Epilepsy (WWE) beneficial: Experience from Kerala Registry of Pregnancy and Epilepsy, India

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P2 - Poster Session 2 (5:30 PM-6:30 PM)

Poster/Presentation
Number 6-004

Objective To determine the effectiveness of Pre-conceptional care (PCC) and determinant of seeking PCC in women with epilepsy (WWE)

Background Birth defect and seizure worsening during pregnancy are major concerns for WWE. Pre-conceptional care offers an opportunity to address these issues, optimize therapy and prescribe folic acid

Design/Methods All primigravida enrolled in this registry in pre-conceptional stage (PCC group) or first trimesters of pregnancy (PRG group) were included. Socio-economic data, Anti-epileptic drugs (AED) and folic acid therapy during pregnancy, seizure, pregnancy and fetal outcome of the two groups were compared to study the effectiveness of PCC

Results There were 320 (30.4%) in PCC group and 732 in PRG group. PCC group had significantly higher education (58.8%, p=.003) and better employment (22.1%, p<.001). The two groups were comparable for epilepsy classification, history of maternal birth defects and family history of epilepsy. A higher proportion of WWE in PRG group were on Phenobarbitone (20.2%, p<.001). Valporate use was significantly higher in PCC group (28.4%, p=.025). Within monotherapy group, use of Levetiracetam (10.8%, p=.017) in PCC group and Carbamazepine (39.1%, p=.04) in PRG group was significantly high. Folic acid usage in pre-pregnancy month (87.5%, p<.001) or first trimester (96.3%, p<.001) was significantly higher in PCC group. Seizure freedom during pregnancy was more in PCC group (62.8%, p=.005) than PRG group (54%). Early fetal loss was better captured in PCC (p=.009) compared to PRG. There was no difference in malformation rate between PCC (7.2%) and PRG group (6.1%, p=.306).

Conclusions PCC improved the pregnancy/first trimester folic acid usage and reduced seizure risk during pregnancy but did not influence the fetal malformation risk.

Authors/Disclosures
PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
Sanjeev V. Thomas, MD, FAAN (Institute for Communicative and Cognitive Neurosciences)	Dr. Thomas has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Wiley India. The institution of Dr. Thomas has received research support from Government of India.

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