{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T01:39:41Z","timestamp":1789004381903,"version":"build-2803163510"},"reference-count":17,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2013,7,12]],"date-time":"2013-07-12T00:00:00Z","timestamp":1373587200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Bial"},{"DOI":"10.13039\/501100003769","name":"Eisai","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003769","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100004330","name":"GlaxoSmithKline","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100004330","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Janssen-Cilag"},{"DOI":"10.13039\/100004336","name":"Novartis","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100004336","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100004339","name":"Sanofi-Aventis","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100004339","id-type":"DOI","asserted-by":"crossref"}]},{"name":"UCB"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2013,9]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To analyze seizure control, dose adjustments, and other changes of antiepileptic drug (<jats:styled-content style=\"fixed-case\">AED<\/jats:styled-content>) treatment during pregnancy in a large cohort of women with epilepsy entering pregnancy on monotherapy with carbamazepine, lamotrigine, phenobarbital, or valproate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Seizure control and <jats:styled-content style=\"fixed-case\">AED<\/jats:styled-content> treatment were recorded prospectively in 3,806 pregnancies of 3,451 women with epilepsy taking part in European and International Registry of Antiepileptic Drugs and Pregnancy (EURAP), an international <jats:styled-content style=\"fixed-case\">AED<\/jats:styled-content> and pregnancy registry.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Findings<\/jats:title><jats:p>Of all cases, 66.6% remained seizure\u2010free throughout pregnancy. Generalized tonic\u2013clonic seizures (<jats:styled-content style=\"fixed-case\">GTCS<\/jats:styled-content>) occurred in 15.2% of the pregnancies. Women with idiopathic generalized epilepsies were more likely to remain seizure\u2010free (73.6%) than women with localization\u2010related epilepsy (59.5%; p\u00a0&lt;\u00a00.0001). Worsening in seizure control from the first to second or third trimesters occurred in 15.8% of pregnancies. The <jats:styled-content style=\"fixed-case\">AED<\/jats:styled-content> dose was increased during pregnancy in 26.0% and a second <jats:styled-content style=\"fixed-case\">AED<\/jats:styled-content> added to the initial monotherapy in 2.6% of all pregnancies. Seizures were more likely to occur in the first trimester in pregnancies with an increased drug load (35%; increased dose and\/or addition of another <jats:styled-content style=\"fixed-case\">AED<\/jats:styled-content>) than in pregnancies without an increased drug load (15.3%) (p\u00a0&lt;\u00a00.0001). Compared with other monotherapies, pregnancies exposed to lamotrigine were less likely to be seizure\u2010free, 58.2% (p\u00a0&lt;\u00a00.0001); had more <jats:styled-content style=\"fixed-case\">GTCS<\/jats:styled-content>, 21.1% (p\u00a0&lt;\u00a00.0001); had a greater likelihood of deterioration in seizure control from first to second or third trimesters, 19.9% (p\u00a0&lt;\u00a00.01), and were more likely to require an increase in drug load, 47.7% (p\u00a0&lt;\u00a00.0001). The mean dose increases from the first to third trimesters were 26% for lamotrigine, 5% for carbamazepine, 11% for phenobarbital, and 6% for valproate. There were 21 cases of status epilepticus (10 convulsive): none with maternal mortality and only one with a subsequent stillbirth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Although the majority of women remain seizure\u2010free throughout pregnancy, our data suggest that a more proactive approach to adjusting the dose of all <jats:styled-content style=\"fixed-case\">AED<\/jats:styled-content>s in pregnancy should be considered, in particular for those pregnancies with seizures occurring in the first trimester and those exposed to lamotrigine, to reduce the risk of deterioration in seizure control.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.12302","type":"journal-article","created":{"date-parts":[[2013,7,12]],"date-time":"2013-07-12T12:59:00Z","timestamp":1373633940000},"page":"1621-1627","source":"Crossref","is-referenced-by-count":243,"title":["Seizure control and treatment changes in pregnancy: Observations from the <scp>EURAP<\/scp> epilepsy pregnancy registry"],"prefix":"10.1111","volume":"54","author":[{"given":"Dina","family":"Battino","sequence":"first","affiliation":[{"name":"Epilepsy Center Department of Neurophysiology and Experimental Epileptology I.R.C.C.S. Neurological Institute \u201cCarlo Besta\u201d Foundation Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torbj\u00f6rn","family":"Tomson","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erminio","family":"Bonizzoni","sequence":"additional","affiliation":[{"name":"Department of Occupational Health \u201cClinica del Lavoro L. Devoto\u201d Section of Medical Statistics and Biometry \u201cG.A. Maccacaro\u201d Faculty of Medicine and Surgery University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Craig","sequence":"additional","affiliation":[{"name":"Department of Neurology, Belfast Health and Social Care Trust Belfast Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dick","family":"Lindhout","sequence":"additional","affiliation":[{"name":"Department of Medical Genetics University Medical Center Utrecht The Netherlands"},{"name":"SEIN \u2013 Epilepsy Institute in the Netherlands Heemstede\/Zwolle The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Sabers","sequence":"additional","affiliation":[{"name":"The Epilepsy Clinic Department of Neurology Rigshospitalet University State Hospital Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilio","family":"Perucca","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Therapeutics University of Pavia, and Clinical Trial Center National Institute of Neurology IRCCS C. Mondino Foundation Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Vajda","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Neurology University of Melbourne Royal Melbourne Hospital Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"EURAP Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,7,12]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2003.029132"},{"issue":"1","key":"e_1_2_7_3_1","first-page":"1","article-title":"Saving Mothers' Lives: reviewing maternal deaths to make motherhood safer: 2006\u20132008. 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