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Abstract Details

Predictors of Seizure Freedom in the Postpartum Period: Findings from the MONEAD Study
Epilepsy/Clinical Neurophysiology (EEG)
S20 - Epilepsy Clinical Outcomes and Prognostication (4:06 PM-4:18 PM)
004

When planning pregnancy, PWECP can be reassured that seizure-freedom in the preconception 9 months is highly predictive of seizure-freedom during pregnancy. However, no studies have prospectively investigated if seizure control during pregnancy similarly predicts the postpartum course. Postpartum is a particularly vulnerable period due to sleep disruption, stress, changing hormones and ASM concentrations, and often complex dosing regimen changes. Newborn safety also is of concern. There is limited data to counsel patients about the risk of postpartum seizures.

To evaluate if seizure-freedom in pregnancy predicts seizure-freedom in the postpartum period in people with epilepsy of childbearing potential (PWECP), and if it varies by seizure type.

Pregnant PWECP, ages 14-45yo, enrolled <20 weeks gestational age in the longitudinal, prospective cohort study, Maternal Outcomes and Neurodevelopmental Effects of Anti-epileptic Drugs (MONEAD), were included in this analysis. Participants were followed until 9 months postpartum, with electronic daily seizure and medication diaries and study visits approximately every three months to verify diary entries and for other study protocol procedures. Using logistic regression, we evaluated the association between seizure-freedom during pregnancy and seizure-freedom postpartum, with further inquiry into seizure types.

331 pregnant PWECP met inclusion criteria for this analysis. Percentages seizure-free were 60% during pregnancy and 61% postpartum. PWECP who were seizure-free during pregnancy were more likely to be seizure-free postpartum (OR 6.53, p<0.0001). The predictive value of seizure-freedom during pregnancy for postpartum seizure freedom was 78% (95% Confidence Interval 72-84%). The strength of the association was the same for focal impaired awareness, convulsive, and generalized seizures.

Our data demonstrated that seizure-freedom during pregnancy, regardless of seizure type, is a robust predictor of seizure-freedom during the postpartum period. These data can be used to counsel patients about seizure risk in the postpartum period.

Authors/Disclosures
Emma C. Osterhaus
PRESENTER
Ms. Osterhaus has received research support from University of Pittsburgh School of Medicine.
Kimford J. Meador, MD, FAAN (Stanford University School of Medicine) The institution of Dr. Meador has received research support from NIH. The institution of Dr. Meador has received research support from Eisai. The institution of Dr. Meador has received research support from Medtronics. The institution of Dr. Meador has received research support from The Epilepsy Consortium.
Jacqueline French, MD, FAAN (NYU Comprehensive Epilepsy Ctr) Dr. French has received personal compensation in the range of $50,000-$99,999 for serving as an officer or member of the Board of Directors for Epilepsy Foundation. The institution of Dr. French has received research support from Epilepsy Study Consortium/ Epilepsy Foundation (Funded by UCB). The institution of Dr. French has received research support from GW/One8 Foundation/FACES. The institution of Dr. French has received research support from NINDS. The institution of Dr. French has received research support from Xenon. The institution of Dr. French has received research support from Cerevel. The institution of Dr. French has received research support from FACES. The institution of Dr. French has received research support from UCB. The institution of Dr. French has received research support from Epilepsy Study Consortium. The institution of Dr. French has received research support from UCB. The institution of Dr. French has received research support from Praxis. Dr. French has received personal compensation in the range of $100,000-$499,999 for serving as a Chief Medical/Innovation Officer with Epilepsy Foundation. Dr. French has a non-compensated relationship as a Consultant with Angelini that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a consultant with Alterity Therapeutics Limited that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a consultant with Bright minds Biosciences that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Cerecin Inc that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Cognizance Biomarkers that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Arvelle that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a consultant with Beacon biosignals that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant, Advisory Board with Biohaven Pharmaceuticals that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Bloom Science Inc that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a consultant, scientific advisory board with Camp4 Therapeutics Corporation that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant, Scientific Advisory Board with Cerebral Therapeutics that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Cerevel that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a SAB with Coda Biotherapeutics that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Genentech Inc that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Crossject that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Eisai, that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Eliem Therapeutics that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Encoded Therapeutics that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with iQure Pharma that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant, SAB with Engrail that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a SAB with Epihunter that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a SAB with Epiminder that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Epitel Inc that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Equilibre BioPharmaceuticals that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Grin Therapeutics that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with GW Pharma that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Janssen Pharmaceutica that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a consultant with Jazz Pharmaceuticals that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Knopp Biosciences that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Lipocine that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with LivaNova that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Longboard Pharmaceuticals that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant, SAB with Lundbeck that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant, SAB with Marinus that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a consultant with Modulight Bio that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant,SAB with Neumirna Therapeutics that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant,SAB with Neurocrine that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Neuroelectrics USA Corporation that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Neuronetics Inc that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Ono Pharmaceutical Co that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant, SAB with Otsuka Pharmaceutical Development that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant, SAB with Ovid Therapeutics Inc that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Paladin Labs Inc that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Rapport Therapeutics that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Praxis that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with PureTech LTY Inc that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a consultant with SK Life Sciences that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Stoke that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Supernus that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a consultant with Takeda that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant, SAB with UCB Inc that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Ventus Therapeutics that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a consulting, steering committee with Xenon that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a consultant with Korro Bio Inc that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with NeuroPro Therapeutics that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Advisory board with Receptor that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Advisory board with Sage Therpeutics that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Advisory Board with Third Rock Ventures that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Vida Ventures Management that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consulting with Pfizer that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consulting with Agrithera, Inc that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a consulting with Autifony therapeutics, Unlimited that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consulting with Baergic Bio that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Biogen that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Biomarin Pharmaceuticals that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Axonis that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Capsida Biotherapeutics that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Access Industries that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Acuta Capital Partners that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Afaci that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Ceribell that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Clinical 好色先生 Alliance that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with EcoR1 Capital that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Cowen and Company LLC that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Epalex that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Iqvia RDS that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Leal Therapeutics Inc that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Neurona Therapeutics that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Neuroventis that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Neurvati that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Neurelis that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Harmony/Epigenyx that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Neuropace that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Noema that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Rafa Laboratories that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Rivervest Venture Partners that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Taysha Gene Therapies that is relevant to AAN interests or activities. Dr. French has a non-compensated relationship as a Consultant with Uniqure that is relevant to AAN interests or activities.
Wesley Kerr, MD, PhD (University of Pittsburgh) Dr. Kerr has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for SK Lifesciences. Dr. Kerr has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biohaven Pharmaceuticals. Dr. Kerr has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EpiTel. Dr. Kerr has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB. Dr. Kerr has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Neurelis. Dr. Kerr has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biohaven Pharmaceuticals. Dr. Kerr has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cerebral Therapeutics. Dr. Kerr has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Epilepsia. The institution of Dr. Kerr has received research support from NINDS. The institution of Dr. Kerr has received research support from American Epilepsy Society. The institution of Dr. Kerr has received research support from 好色先生. Dr. Kerr has received publishing royalties from a publication relating to health care.
Angela K. Birnbaum, PhD (University of Minnesota) The institution of Dr. Birnbaum has received research support from National Institutes of Health. The institution of Dr. Birnbaum has received research support from Randy Shaver Cancer and Research Foundation. Dr. Birnbaum has received intellectual property interests from a discovery or technology relating to health care.
Paula E. Voinescu, MD (Brigham and Women'S Hospital) The institution of Dr. Voinescu has received research support from Epilepsy Foundation of New England. The institution of Dr. Voinescu has received research support from BWH - Connors Center. The institution of an immediate family member of Dr. Voinescu has received research support from American Epilepsy Society. Dr. Voinescu has received personal compensation in the range of $500-$4,999 for serving as a Speaker with Phillipines League Against Epilepsy. Dr. Voinescu has received personal compensation in the range of $500-$4,999 for serving as a PhD Opponent with University of Bergen, Norway. Dr. Voinescu has a non-compensated relationship as a Board Member and Chair with My Epilepsy Story that is relevant to AAN interests or activities. Dr. Voinescu has a non-compensated relationship as a Speaker with Epilepsy Foundation that is relevant to AAN interests or activities. Dr. Voinescu has a non-compensated relationship as a Grant Reviewer with American Epilepsy Society that is relevant to AAN interests or activities. Dr. Voinescu has a non-compensated relationship as a Member of Scientific Advisory Committee with North American AED Pregnancy Registry that is relevant to AAN interests or activities.
Elizabeth Gerard, MD (Northwestern University) Dr. Gerard has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Xenon. The institution of Dr. Gerard has received research support from NIH/NINDS. The institution of Dr. Gerard has received research support from Xenon Pharmaceuticals. The institution of an immediate family member of Dr. Gerard has received research support from NIH. The institution of Dr. Gerard has received research support from Eisai, Inc. (via Stanford University). Dr. Gerard has received publishing royalties from a publication relating to health care.
Page B. Pennell, MD, FAAN (University of Pittsburgh School of Medicine) The institution of Dr. Pennell has received research support from NIH. Dr. Pennell has received publishing royalties from a publication relating to health care.