No association between pregnancy, improved catamenial epilepsy seizure rate

Key takeaways:

• The evidence was inconclusive for association with pregnancy and improvement in catamenial seizure pattern.
• Researchers said a larger study is needed to validate the results.

PHILADELPHIA — Among a small cohort of women with epilepsy who were attempting to conceive a child, no associations were found between pregnancy and change in catamenial seizure reduction, according to a poster presentation.

“It had been previously told to patients that, if you have this type of epilepsy, your seizures would get better in pregnancy,” Emma Osterhaus, BS, research assistant in the department of neurology at the University of Pittsburgh School of Medicine, told Healio at the American Neurological Association annual meeting.

Osterhaus and fellow researchers wanted to compare seizure outcomes during pregnancy in women with epilepsy by analyzing their history of catamenial patterns, as previous research has reported that women with epilepsy were more likely to see improved seizure frequency during pregnancy due to higher sensitivity to fluctuations in sex steroid hormones.

Their longitudinal, prospective cohort study included 89 women, including 58 with no seizure activity and 31 with seizure activity. Among the 28 women with seizures who completed the study as well as at least one tracking cycle, 13 had a confirmed pregnancy (seven without catamenial patterns, mean age 30.6 years; six with catamenial patterns, mean age 30.0 years) and 10 had no confirmed pregnancy.

Researchers queried all women with epilepsy at enrollment for history of perceived catamenial patterns, then, once enrolled, the women utilized a daily diary customized app for menstrual and seizure tracking from preconception through delivery.

For this secondary analysis, enrollees were excluded if they chose to discontinue the study, if they did not become pregnant, or if their diary data was inadequate (defined as 0.01) for observed groups.

Results showed no significant association between change in seizure rate in pre-conception catamenial patterns (P = 0.43), although data show there may be an association between seizure reduction rate during pregnancy for generalized seizures (P = 0.058).

“We found there was not enough evidence to say catamenial patterns improved in pregnancy,” Osterhaus told Healio. “We were expecting to find that seizure rate would improve.”