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A history of non-tonic-clonic seizures, seizures in the pre-pregnancy year, and tonic-clonic seizures in the last 3 months are the strongest predictors of seizure risk in pregnant women with epilepsy.
A study led by Fatima Junaid et al. has pinpointed key risk factors connected with seizure occurrence in pregnant women and the general adult population with epilepsy, shedding light on critical areas for targeted prevention and clinical decision-making.
The study aimed to systematically recognize risk factors for seizures in pregnant women suffering from epilepsy and in adults with epilepsy more broadly. Researchers conducted an umbrella review of systematic reviews and clinical practice guidelines. The search spanned major databases—including MEDLINE, Embase, CINAHL, and TRIP PRO—as well as grey literature sources, without imposing language restrictions.
The review excluded studies focused solely on pediatric populations and prioritized identifying risk factors or prediction models applicable to adult individuals, especially during pregnancy. Out of 3,406 citations, 13 high-quality documents fulfilled inclusion criteria: 10 clinical guidelines and 3 systematic reviews. From these, 26 distinct risk factors were identified:
The risk factors were thematically categorized into 5 broad domains: Seizure type, seizure control, anti-seizure medication, neurological factors, epilepsy, and medical history. Notably, 3 predictors were consistently highlighted across multiple sources:
Among pregnant women with epilepsy, 3 factors were notably linked with more than a 2-fold heightened seizure risk:
The findings underscore the value of integrating well-established seizure risk factors into clinical care pathways—particularly for pregnant women, where seizure control is fundamental for both maternal and fetal outcomes. Despite strong consensus on many predictors, the study emphasizes the requisition for additional research into the practical implementation of seizure prediction tools in real-world settings. Such tools could play a transformative role in boosting maternal health outcomes and optimizing epilepsy care strategies across diverse adult populations.
European Journal of Obstetrics & Gynecology and Reproductive Biology
Seizure prediction in pregnant women with epilepsy: An umbrella review of clinical practice guidelines and systematic reviews
Fatima Junaid et al.
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