{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:22:49Z","timestamp":1791418969488,"version":"4.3.3"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T00:00:00Z","timestamp":1756512000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T00:00:00Z","timestamp":1756512000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epileptic Disorders"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Folic acid supplementation is recommended by WHO for all pregnancies to reduce the risk of neural tube defects and improve neurodevelopmental outcomes. No study to date directly compares the effects on children's outcomes for different folic acid dosages taken by pregnant people with epilepsy. Thus, the optimal folic acid dosing remains unclear, with current guidelines recommending a wide range of doses (.4\u20135\u2009mg\/day). The optimal folic acid dosage is influenced by multiple factors, including dietary intake, food fortification, genetic background, interactions with antiseizure medications, and comorbidities such as anemia or obesity. This study aimed to survey experts on their current clinical practices and recommendations regarding folic acid supplementation dosage for pregnant people with epilepsy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A survey was distributed to expert providers in the international Epilepsy in Childbearing Age through Menopause consortium. The survey collected open\u2010ended responses regarding recommendations and practices for folic acid supplementation in pregnant people with epilepsy, categorizing responses by dosage ranges and clinical scenarios.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty\u2010two experts responded to the survey: 42 adult epileptologists, 3 pediatric neurologists, 2 obstetrician\/maternal\u2010fetal medicine specialists, 1 epilepsy pharmacist, and 4 unspecified. Geographically, respondents were primarily from North America, a region with mandatory folate fortification, as well as from Northern Europe and Asia, where such practices vary. The majority of the respondents (73.1%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200938) recommended folic acid supplementation doses of 1\u20132\u2009mg\/day, with a recommendation of either 1\u2009mg folic acid alone (24\/52) or 1\u2009mg folic acid plus prenatal vitamins (12\/52). Lower doses (.4\u2013.8\u2009mg\/day) were recommended by 15.4% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20098). Additionally, 42.3% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200922) of respondents recommended individualized dosing strategies, particularly higher doses for patients on valproate (36.5%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200919) or enzyme\u2010inducing ASMs (17.3%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20099). A small proportion (1.9%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091) recommended routine folate serum level testing to guide supplementation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>This international expert survey revealed that folate supplementation was favored at doses of 1\u20132\u2009mg\/day for pregnant people with epilepsy, reflecting a shift away from previously higher\u2010dose practices. Many experts advocated individualized dosing strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epd2.70097","type":"journal-article","created":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T14:48:57Z","timestamp":1756565337000},"page":"1209-1216","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Folate supplement dosage for pregnant people with epilepsy: Survey of international experts recommendation and current practices"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0392-6661","authenticated-orcid":false,"given":"Yi","family":"Li","sequence":"first","affiliation":[{"name":"Department of Neurology and Neurological Sciences Stanford University School of Medicine  Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Bromley","sequence":"additional","affiliation":[{"name":"Division of Neuroscience University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimford J.","family":"Meador","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurological Sciences Stanford University School of Medicine  Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marte\u2010Helene","family":"Bj\u00f8rk","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine University of Bergen  Bergen Norway"},{"name":"Department of Neurology Haukeland University Hospital  Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Page B.","family":"Pennell","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. Emanuela","family":"Voinescu","sequence":"additional","affiliation":[{"name":"Department of Neurology Mass General Brigham, Harvard University  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"For the Epilepsy in the Childbearing Age through Menopause Consortium (ECAM)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,30]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980012000067"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.20563"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/09691413221102321"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000200669"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000006073"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2017.3897"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000008757"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41421-022-00512-0"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/srep01465"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-019-44794-z"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-013-3086-7"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/ppe.12414"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.38747"},{"key":"e_1_2_10_15_1","unstructured":"Dietary Reference Intakes for Thiamin Riboflavin Niacin Vitamin B(6) Folate Vitamin B(12) Pantothenic Acid Biotin and Choline. 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