BOSTON, MA, Oct 12, 2023 – The Epilepsy & Pregnancy Medical Consortium, an expert panel of leading epileptologists and OB-GYN researchers/practitioners, announced updated best practice recommendations for people with epilepsy who are considering pregnancy, are pregnant, or are postpartum. These new best practices are based on the findings of the groundbreaking study Maternal Outcomes and Neurodevelopment Effects of Antiepileptic Drugs (MONEAD) and its predecessor study Fetal Antiepileptic Drug Exposure and Cognitive Outcomes at Age 6 Years (NEAD study).
MONEAD followed 565 women, including pregnant women with epilepsy, non-pregnant women with epilepsy, and pregnant women without epilepsy in order to explore the impact of various anti-seizure medications on seizure frequency, maternal outcomes, breastfeeding, and child outcomes (such as verbal and intellectual abilities) through six years of age.
Based on the results of this study, the Epilepsy & Pregnancy Medical Consortium asserts that with proper planning and therapeutic monitoring of pregnancy-suitable anti-seizure medications, such as lamotrigine and levetiracetam monotherapy, people with epilepsy can have safe, healthy pregnancies and healthy babies.
The data also countered the misconception that it is not safe for people who take anti-seizure medications to breastfeed their babies. In fact, neurodevelopmental outcomes at age six were better in children exposed to anti-seizure medications in utero who were breastfed compared to those who were not breastfed.
Dr. Page Pennell, M.D., F.A.E.S., is the department chair of neurology at the University of Pittsburgh School of Medicine and co-investigator of the MONEAD study.
“There’s a lot of information out there about the danger of anti-seizure medications. But we know at this time that there are some medications that are very safe to use during the childbearing years. But with that in mind it’s important that when it is time to have children we have everything in place, and then we have a planned pregnancy,” said Dr. Pennell.
Dr. Elizabeth Gerard, M.D., is an epileptologist and professor of neurology at Northwestern University.
“We have a research study that suggests that the children who were breastfed [from a parent who was taking] anti-seizure medicines actually had higher IQs than those [children] who were not breastfed. So we emphasize that for most of our drugs, we have strong evidence that there is a low risk of breastfeeding or almost no documented risk. For those [anti-seizure medications for which] we don’t have strong evidence, it is more of a theoretical risk,” said Dr. Gerard.
Because family planning can have such a positive impact on pregnancy outcomes for epilepsy patients, The Epilepsy & Pregnancy Medical Consortium also provides best-practice recommendations for contraceptive use and other considerations for patients during their childbearing years. Some anti-seizure medications can interfere with certain hormonal contraceptives, rendering them less effective.
The Epilepsy & Pregnancy Medical Consortium mission is to reach as many patients and clinicians as possible so they can use this new data to guide their healthcare decisions and understand the best treatment options. For information regarding the MONEAD study, care recommendations, downloadable tools, resources, and more, visit their website: epilepsypregnancy.com