Self-Discontinuation of Antiseizure Medication During Pregnancy Increases Postpartum Seizure Frequency

Abstract

Objectives: The study aimed to investigate the rate of unplanned pregnancies, changes in seizure frequencies during the 6 months before the pregnancy, during the pregnancy, and the 6 months after the pregnancy, and antiseizure medication (ASM) compliances in women with epilepsy (WWEs). Materials and Methods: The study retrospectively evaluated WWEs who were followed up in the epilepsy outpatient clinic of a training and research hospital between 1997-2021 and had used ASMs for at least 6 months prior to their pregnancy. Results: The study assessed a total of 158 pregnancies for 77 WWEs, with 112 pregnancies resulting in live births, 71.4% of which were unplanned pregnancies. Unplanned pregnancies are more common in less educated women (p = 0.02). Of the women, 35 self-discontinued their ASMs during pregnancy, and these women were younger than the WWEs who continued taking their ASMs (p = 0.003). In addition, folic acid supplement use was lower in women who self-discontinued their ASMs (p = 0.031). The rate of increase in seizure frequency during postpartum period compared to pregnancy was higher in women who self -discontinued ASMs (p = 0.032). Conclusion: Self–discontinuation of ASM during pregnancy is related to an increase in postpartum seizure frequency. WWEs should be given advice on how to minimize the risk of seizure during the postpartum period.