{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T01:39:40Z","timestamp":1789004380147,"version":"build-2803163510"},"reference-count":22,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,7,24]],"date-time":"2020-07-24T00:00:00Z","timestamp":1595548800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001411","name":"Indian Council of Medical Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001411","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>We compared women with drug\u2010resistant focal epilepsy who had undergone surgery (WWE\u2010S) with those who were managed medically (WWE\u2010M) for maternal and fetal outcomes of their pregnancies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We classified all WWE\u2010S who were enrolled in a prospective registry of epilepsy and pregnancy (1998\u20102015) as those who underwent the surgery before pregnancy (WWE\u2010SF) or after pregnancy (WWE\u2010PF). The comparator group (WWE\u2010M) was twice that number of age\u2010matched women with focal epilepsy in this registry. Their clinical profile, anti\u2010epileptic drug (AED) use, and pregnancy outcomes were extracted from the records of the registry.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The number of completed pregnancies with known outcome was 74 for WWE\u2010S (67 WWE\u2010SF and 7 WWE\u2010PF) and 134 for WWE\u2010M. Seizures increased during pregnancy for fewer WWE\u2010SF than for WWE\u2010M (14.9% vs 39.6%, <jats:italic>P<\/jats:italic> = .001). Compared to WWE\u2010M, fewer WWE\u2010SF had dose escalation during pregnancy (28.4% vs 14.9%, <jats:italic>P<\/jats:italic> = .025). Preterm deliveries were more frequent in WWE\u2010SF than WWE\u2010M (24.6% vs 12.2%, <jats:italic>P<\/jats:italic> = .029). The differences between the WWE\u2010SF and WWE\u2010M regarding the rates of fetal loss (10.4% vs 6.7%, <jats:italic>P<\/jats:italic> = .255), major congenital malformations (8.5% vs. 11.1%, <jats:italic>P<\/jats:italic> = .395), and development quotient at 1\u00a0year of age\u00a0&lt;85 (42.5% vs 42.3%, <jats:italic>P<\/jats:italic> = .569) were not statistically significant. Compared to WWE\u2010PF, fewer WWE\u2010SF had AED dose escalation (14.9% vs 85.7%, <jats:italic>P<\/jats:italic> = .001) or increase in seizures (14.9% vs 100%, <jats:italic>P<\/jats:italic> = .001) during pregnancy. WWE\u2010SF had fewer infants with development quotient\u00a0&lt;85 (41.0% vs 100%, <jats:italic>P<\/jats:italic> = .005).<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>WWE\u2010SF can expect better control of seizures and decreased AED burden during pregnancy than WWE with focal epilepsies managed with medicines only. WWE who undergo surgery for epilepsy before their pregnancies can expect fewer seizures and lower AED burden during pregnancy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.16613","type":"journal-article","created":{"date-parts":[[2020,7,24]],"date-time":"2020-07-24T16:53:37Z","timestamp":1595609617000},"page":"1758-1763","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Women with drug\u2010resistant epilepsy: Surgery or pregnancy first?"],"prefix":"10.1111","volume":"61","author":[{"given":"Sai Satish","family":"Kandraju","sequence":"first","affiliation":[{"name":"Department of Neurology Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST) Trivandrum India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manna","family":"Jose","sequence":"additional","affiliation":[{"name":"Department of Neurology Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST) Trivandrum India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reshma A.","family":"Salini","sequence":"additional","affiliation":[{"name":"Department of Neurology Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST) Trivandrum India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veena","family":"Pavithran","sequence":"additional","affiliation":[{"name":"Department of Neurology Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST) Trivandrum India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Samuel Peedicail","sequence":"additional","affiliation":[{"name":"Department of Neurology Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST) Trivandrum India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0972-3307","authenticated-orcid":false,"given":"Ramsekhar N.","family":"Menon","sequence":"additional","affiliation":[{"name":"Department of Neurology Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST) Trivandrum India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8564-8436","authenticated-orcid":false,"given":"Ashalatha","family":"Radhakrishnan","sequence":"additional","affiliation":[{"name":"Department of Neurology Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST) Trivandrum India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajith","family":"Cherian","sequence":"additional","affiliation":[{"name":"Department of Neurology Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST) Trivandrum India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathew","family":"Abraham","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST) Trivandrum India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George C.","family":"Vilanilam","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST) Trivandrum India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5307-3551","authenticated-orcid":false,"given":"Sanjeev V.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Neurology Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST) Trivandrum India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,7,24]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2012.03439.x"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000227919.81208.b2"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30107-8"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2015.09.003"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-017248"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200002033420503"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200108023450501"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25205"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2016.04.002"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2017.00191"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13632"},{"key":"e_1_2_8_13_1","volume-title":"Developmental Assessment Scales for Indian Infants(DASII) Revision of 1970 Baroda Norms from Birth to 30 months on Bayley Scales of Infant Development (BSID)","author":"Pathak P","year":"1998"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.12302"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2013.06.026"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpme.1979.7.1.3"},{"issue":"8","key":"e_1_2_8_17_1","first-page":"979","article-title":"Affect of seizures during gestation on pregnancy outcomes in women with epilepsy","volume":"66","author":"Yi\u2010HuaChen H\u2010Y","year":"2009","journal-title":"Arch Neurol"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2008.08.010"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.321.7262.674"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneurol.2011.133"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2009.02336.x"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000002119"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781118531037"}],"container-title":["Epilepsia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fepi.16613","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/epi.16613","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/epi.16613","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/epi.16613","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,5]],"date-time":"2023-09-05T10:55:49Z","timestamp":1693911349000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/epi.16613"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,24]]},"references-count":22,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2020,8]]}},"alternative-id":["10.1111\/epi.16613"],"URL":"https:\/\/doi.org\/10.1111\/epi.16613","archive":["Portico"],"relation":{},"ISSN":["0013-9580","1528-1167"],"issn-type":[{"value":"0013-9580","type":"print"},{"value":"1528-1167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,24]]},"assertion":[{"value":"2019-03-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-06-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}