Abstract
Girls and women constitute nearly 50% of all epilepsy cases. Apart from the disease symptoms, epilepsy and antiseizure medications (ASMs) may also affect the reproductive function, pregnancy and even the health of their offspring. Therefore, it is very important to identify and summarize the problems and risks for women with epilepsy (WWE) of childbearing age, and offer internationally recognized methods through multidisciplinary collaboration. In this review, we summarize the reproduction-related problems with WWE and propose multidisciplinary management by epileptologists, gynecologists and obstetricians, as well as other experts, from preconception to delivery. Large, multicenter registries are needed to advance our knowledge on new ASMs and their effects on WWE and their offspring.
Highlights
Epilepsy is a serious neurological disorder characterized by recurring seizures and accompanied by many comorbidities [1]
Epilepsy and antiseizure medications (ASMs) have been verified to interact with regulations of sex hormones, leading to unsatisfactory seizure control and impaired reproductive function, causing a polycystic ovarian syndrome (PCOS) that may lead to infertility in women with epilepsy (WWE) [4]
Folic acid supplementation is associated with a lower risk of spontaneous abortion [30], better verbal outcomes [31] and a reduced risk of major congenital malformations [32] in fetus or postnatal babies women with epilepsy, In addition, women taking ASMs are at a higher risk of low serum folate compared to the general population, probably because that ASMs which could induce the cytochrome P-450 enzyme such as CBZ and PHT, could interfere with folate metabolism [33]
Summary
Epilepsy is a serious neurological disorder characterized by recurring seizures and accompanied by many comorbidities [1]. Folic acid supplementation is associated with a lower risk of spontaneous abortion [30], better verbal outcomes [31] and a reduced risk of major congenital malformations [32] in fetus or postnatal babies women with epilepsy, In addition, women taking ASMs are at a higher risk of low serum folate compared to the general population, probably because that ASMs which could induce the cytochrome P-450 enzyme such as CBZ and PHT, could interfere with folate metabolism [33].
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