AEDs patterns and seizure activity during pregnancy
In Table 1, the AED treatment patterns in the first trimester were
significantly different between the planned and unplanned pregnancy
groups (P < 0.001, Chi-square test). In the
planned-pregnancy group, 66.0% of the pregnancies in WWE remained in
monotherapy in the first trimester, 32.4% in polytherapy, and 1.6%
with no AEDs. In the unplanned-pregnancy group, 58.1% did not take
AEDs, 28.0% remained in monotherapy, 12.8% remained in polytherapy,
and 1.0% were treated with traditional Chinese medicine. No pregnancy
in the planned group was prescribed VPA monotherapy during the first
trimester, but in the unplanned group, 4.8% received VPA monotherapy
(P = 0.002, Chi-square test). The proportion of WWE taking VPA in
polytherapy was similar between the planned and unplanned groups (5.9%
vs 5.5%; P = 0.884, Chi-square test). The most commonly
prescribed AEDs as monotherapy was LTG (52.4%), LEV (24.2%), and OXC
(18.5%) in the planned group, and LTG (30.9%), VPA (17.3%), and
carbamazepine (CBZ, 14.8%) in the unplanned group respectively (Figure
2). For polytherapy, the most commonly prescribed combination pattern in
the planned group was LEV plus OXC (21.3%), followed by LTG plus LEV
(18.0%) and LTG plus CBZ (18.0%). Whereas in the unplanned group, the
most common pattern was LTG plus VPA (18.9%), followed by CBZ plus
phenobarbital (PB) (10.8%) and CBZ plus VPA (10.8%).
During pregnancy, the number of GTCS in the unplanned group (2
[1-4]) was significantly more than that in the planned group (1
[1-2]; P = 0.002, Mann–Whitney U test). In addition, up to
41.0% of pregnancies in the planned group achieved being seizure free
during pregnancy, which was significantly more than that in the
unplanned group (22.8%; P < 0.001,
Chi-square test).