Abstracts

There are a number of worldwide prospective pregnancy registers gathering data in an effort to determine the safest strategies for the treatment of women with epilepsy who are pregnant or planning to become pregnant. The Irish Epilepsy and Pregnancy Register was initiated in May 2001. An important aim of the Register is to educate people about epilepsy and pregnancy by giving pre-conceptual, pregnancy and post pregnancy advice. Some anti-epileptic drugs have anti-folate effects; a higher dose of 5mg folic acid is recommended for all women with epilepsy of childbearing age. As neural tube closure occurs within the first 4 weeks of pregnancy, it is important to educate women about pre-conceptual folic acid intake. This study aims to determine the rate of pre-conceptual and pregnancy use of folic acid.
This is a prospective Register of women with epilepsy in Ireland who are pregnant. It is co-ordinated by an Epilepsy Research Nurse and is based at the Clinical Research Centre, at Beaumont Hospital in Dublin 9. All Neurologists, General Practitioners, Obstetricians and other health professionals are regularly reminded of the Register and both health professionals and women themselves are invited, with consent, to enrol into the study. All relevant information is gathered and stored on a database. At 3 months after expected date of delivery, pregnancy outcome is determined from the General Practitioner.
To-date, 134 pregnancies are registered with 71 full outcome reports to the Irish Epilepsy and Pregnancy Register. Ninety three percent used folic acid supplementation at some stage in their pregnancy. Fifty seven percent (76) took folic acid was pre-conceptually, 41% (55) initiated folic acid after pregnancy diagnosis, and 2% (3) took folic acid at an unknown stage in pregnancy. Sixty nine percent (92) of women used a 5 mg folic acid tablet during some stage of their pregnancy, 22% (29) used a 0.4 mg tablet, 5% (7) used an unknown strength of folic acid tablet, 3% (4) used no folic acid and 1% (two women) used a 1.2 mg/10mg tablet. Seventy nine percent (60) of the pre-conceptual folic acid intake was a 5 mg tablet, 17% (13) was a 0.4 mg tablet, 4% used a 1.2mg/10mg tablet or an unknown dose.
The results of this study re-inforces the necessity for ongoing education about the need for pre-conceptual supplementation of folic acid in women of childbearing potential. We now initiate education at time of diagnosis or at time of first contact with our unit.
[Supported by: The Irish Brain Research Foundation and the Monkstown Hospital Trust.]