Vital information in a report on pregnancy and anti-epileptic drugs (AEDs) is unlikely to reach thousands of women with epilepsy, warns Epilepsy Action. The charity fears that this is putting mothers and unborn children at unnecessary risk.
The report, Autism Spectrum Disorders Following In Utero Exposure to Antiepileptic Drugs , was published in Neurology earlier this week. It concluded that there is a link between the AED sodium valproate and having children with autistic spectrum disorder (ASD). According to the report, women taking sodium valproate face a seven times greater risk of having a child with ASD than women without epilepsy.
Epilepsy Action welcomes this report but worries that such vital information is unlikely to reach women with epilepsy. A survey by the charity reveals that 25 per cent of women with epilepsy who were pregnant or had given birth in the previous five years did not receive any preconception counselling. Also, 68 per cent had not been offered joint care by an epilepsy specialist nurse and midwife. This is despite clear guidelines from the National Institute for Health and Clinical Excellence (NICE) on the management of epilepsy.
The charity also fears that many health professionals responsible for the care of women with epilepsy - obstetricians, midwives, health visitors, and general and community practitioners – are still not aware of these issues.
Around 5,000 women with epilepsy become pregnant every the year in the UK. The majority of women will experience uncomplicated pregnancies and give birth to healthy babies. The aim in epilepsy care is that women achieve good seizure control while
posing the minimum risk to the unborn child. Women should never stop taking epilepsy medication without consulting their GP and epilepsy specialist as this could be potentially harmful to their health and their unborn child.
Professor Gus Baker of the University of Liverpool's Division of Neurosciences and one of the authors of the report said: "The potential risk for autism in this study was substantial for children whose mothers took valproate while pregnant, but more research needs to be done since these are early findings. However, women who take valproate while pregnant should be informed of the possible risks of autism and are encouraged to discuss them with their doctor.”
Simon Wigglesworth, Epilepsy Action's deputy chief executive, said: "We urge all women with epilepsy to seek pre-conception counselling well before planning a family, so they can discuss the options open to them with their health professional.”
Epilepsy Action's current Mothers in mind: healthy births campaign is aimed at reducing the risks to mother and baby during pregnancy. It underlines the critical need for health professionals to increase their knowledge of how to best manage the condition in women before, during and after pregnancy. Information packs are available to women and their health professionals by visiting http://www.epilepsy.org.uk/mothersinmind, or calling the Epilepsy Helpline freephone 0808 800 5050.
Epilepsy Action is the UK's largest member-led epilepsy organisation. Last year alone the organisation directly helped over 731,000 people through a range of services, including its Epilepsy Helpline, advice and information centre, and branch network.