Seizure Freedom During Pregnancy Strongly Predicts Postpartum Seizure Control

For people with epilepsy of childbearing potential (PWECP) seizure freedom during pregnancy was shown to be a strong predictor of seizure freedom in the postpartum period. This finding from an analysis of results of the Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD) study (NCT01730170) was presented at the American Academy of Neurology (AAN) 2025 Annual Meeting.

The prospective cohort study included 331 pregnant PWECP from the MONEAD cohort aged 14 to 45 years and ≤20–weeks gestation. Participants tracked seizures daily using electronic diaries, with study visits approximately every 3 months extending through 9 months postpartum. Researchers used logistic regression analysis to assess the association between seizure freedom during pregnancy and seizure freedom during the postpartum period. Multiple seizure types were considered in the analysis.

• 60% of participants were seizure-free during pregnancy.
• 61% of participants were seizure-free in the postpartum period.
• Those who were seizure-free during pregnancy had significantly higher odds of remaining seizure-free postpartum (odds ratio [OR], 6.53; P<.0001).
• Seizure freedom during pregnancy had a 78% predictive value for postpartum seizure freedom (95% CI, 72% to 84%).

The researchers noted that the association they identified between seizure freedom during pregnancy and the postpartum period were consistent regardless of seizure type (focal impaired awareness, convulsive, and generalized).