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).