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<?xml version="1.0" encoding="UTF-8"?><!DOCTYPE html> <html lang="en" dir="ltr" version="HTML+RDFa+MathML 1.1" xmlns:dc="http://purl.org/dc/terms/" xmlns:foaf="http://xmlns.com/foaf/0.1/" xmlns:og="http://ogp.me/ns#" xmlns:rdfs="http://www.w3.org/2000/01/rdf-schema#" xmlns:sioc="http://rdfs.org/sioc/ns#" xmlns:sioct="http://rdfs.org/sioc/types#" xmlns:skos="http://www.w3.org/2004/02/skos/core#" xmlns:xsd="http://www.w3.org/2001/XMLSchema#" xmlns:mml="http://www.w3.org/1998/Math/MathML"> <head profile="http://www.w3.org/1999/xhtml/vocab">  <link rel="dns-prefetch" href="//securepubads.g.doubleclick.net" /> <link rel="dns-prefetch" href="//d1bxh8uas1mnw7.cloudfront.net" /> <link rel="dns-prefetch" href="//scholar.google.com" /> <meta http-equiv="Content-Type" content="text/html; charset=utf-8" /> <link rel="shortcut icon" href="https://pn.bmj.com/sites/default/themes/bmjj/favicon.ico" type="image/vnd.microsoft.icon" /> <meta name="viewport" content="width=device-width, initial-scale=1" /> <script>window.dataLayer = window.dataLayer || [];window.dataLayer.push({"page":{"hwTitle":"Preconception counselling in women with epilepsy","hwUrl":"https://pn.bmj.com/content/24/6/478","hwPath":"/content/24/6/478","hwType":"journal page"},"user":{"hwMemberID":"","hwLoggedIntoInstitutionID":"","hwLoggedIntoInstitution":"","hwAccessUsageTerms":"guest","hwRegisteredUser":"no","hwHasFullTextAccess":"no","hwEntitled":"no","mail":"e3b0c44298fc1c149afbf4c8996fb92427ae41e4649b934ca495991b7852b855"},"content":{"hwIssueDate":"2024-12-01","hwIssueDateTime":"2024-12-01 00:00:00","hwPublicationDate":"2024-11-17","hwPublicationDateTime":"2024-11-17 21:03:29","hwNlmArticleType":"other","hwDOI":"10.1136/pn-2023-003902","hwAuthors":"Emily J Pegg,Rebecca Bromley,Farhat Mirza,Ellen Campbell","hwContributors":"","hwIsEarlyRelease":"no","hwEissn":"1474-7766","hwPissn":"1474-7758","hwVolume":"24","hwIssue":"6","hwArticleType":"How to do it","hwTabView":"main_tab","hwViewType":"","hwAccessType":"Paywall","hwOpenAccess":"no","hwFreeAccess":"no","hwTaxonomy":"","hwCorpusCode":"practneurol","hwType":"article","hwSubtitle":null,"hwOverline":null,"hwPisaId":"practneurol;24/6/478","hwFirstPage":"478","hwLastPage":"484","hwIsLatestVersion":"yes","hwIsCurrentIssue":"no","hwIsOpenIssue":"no","hwHasFullText":"yes","hwHasPDF":"yes","hwParentTitle":"Practical Neurology: 24 (6)","hwElectronicPubDate":"2024-11-17","hwElectronicPubDateTime":"2024-11-17 21:03:29"}}); //--><!]]></script> <link rel="canonical" href="https://pn.bmj.com/content/24/6/478" /> <meta name="Generator" content="Drupal 7 (http://drupal.org)" /> <link rel="alternate" type="application/pdf" title="Full Text (PDF)" href="/content/24/6/478.full.pdf" /> <link rel="alternate" type="text/plain" title="Full Text (Plain)" href="/content/24/6/478.full.txt" /> <meta name="issue_cover_image" content="https://pn.bmj.com/sites/default/files/highwire/practneurol/24/6.cover-source.jpg" /> <meta name="type" content="article" /> <meta name="category" content="other" /> <meta name="HW.identifier" content="/practneurol/24/6/478.atom" /> <meta name="HW.pisa" content="practneurol;24/6/478" /> <meta name="DC.Format" content="text/html" /> <meta name="DC.Language" content="en" /> <meta name="DC.Title" content="Preconception counselling in women with epilepsy" /> <meta name="DC.Identifier" content="10.1136/pn-2023-003902" /> <meta name="DC.Date" content="2024-12-01" /> <meta name="DC.Publisher" content="BMJ Publishing Group Ltd" /> <meta name="DC.Rights" content="© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ." /> <meta name="DC.AccessRights" content="restricted" /> <meta name="DC.Relation" content="10.1136/pn-2024-004387" /> <meta name="DC.Description" content="Pregnancy and the postpartum period are potentially high-risk periods for women with epilepsy and their babies. All women with epilepsy should have the opportunity for preconception counselling with the aim of reducing risk, optimising outcomes for the potentially developing fetus and enabling informed decision-making. This article provides an evidence-based framework for preconception counselling discussion, including the review of diagnosis and of current antiseizure medication, the risk to the fetus in relation to antiseizure medication and maternal seizures, maternal morbidity, SUDEP risk, folic acid supplements, contraception, breastfeeding and safety advice. No data are available." /> <meta name="DC.Contributor" content="Emily J Pegg" /> <meta name="DC.Contributor" content="Rebecca Bromley" /> <meta name="DC.Contributor" content="Farhat Mirza" /> <meta name="DC.Contributor" content="Ellen Campbell" /> <meta name="article:published_time" content="2024-12-01" /> <meta name="article:section" content="How to do it" /> <meta name="citation_title" content="Preconception counselling in women with epilepsy" /> <meta name="citation_abstract" lang="en" content="<p>Pregnancy and the postpartum period are potentially high-risk periods for women with epilepsy and their babies. All women with epilepsy should have the opportunity for preconception counselling with the aim of reducing risk, optimising outcomes for the potentially developing fetus and enabling informed decision-making. This article provides an evidence-based framework for preconception counselling discussion, including the review of diagnosis and of current antiseizure medication, the risk to the fetus in relation to antiseizure medication and maternal seizures, maternal morbidity, SUDEP risk, folic acid supplements, contraception, breastfeeding and safety advice.</p>" /> <meta name="citation_journal_title" content="Practical Neurology" /> <meta name="citation_publisher" content="BMJ Publishing Group Ltd" /> <meta name="citation_publication_date" content="2024/12/01" /> <meta name="citation_mjid" content="practneurol;24/6/478" /> <meta name="citation_id" content="24/6/478" /> <meta name="citation_public_url" content="https://pn.bmj.com/content/24/6/478" /> <meta name="citation_abstract_html_url" content="https://pn.bmj.com/content/24/6/478.abstract" /> <meta name="citation_full_html_url" content="https://pn.bmj.com/content/24/6/478.full" /> <meta name="citation_pdf_url" content="https://pn.bmj.com/content/practneurol/24/6/478.full.pdf" /> <meta name="citation_issn" content="1474-7758" /> <meta name="citation_issn" content="1474-7766" /> <meta name="citation_doi" content="10.1136/pn-2023-003902" /> <meta name="citation_pmid" content="38937091" /> <meta name="citation_volume" content="24" /> <meta name="citation_issue" content="6" /> <meta name="citation_article_type" content="Other" /> <meta name="citation_section" content="How to do it" /> <meta name="citation_firstpage" content="478" /> <meta name="citation_lastpage" content="484" /> <meta name="citation_author" content="Emily J Pegg" /> <meta name="citation_author_institution" content="Manchester Centre for Clinical Neurosciences" /> <meta name="citation_author_institution" content="Salford Royal Hospital" /> <meta name="citation_author_institution" content="Division of Neuroscience" /> <meta name="citation_author_institution" content="University of Manchester" /> <meta name="citation_author_orcid" content="http://orcid.org/0000-0001-5018-5494" /> <meta name="citation_author" content="Rebecca Bromley" /> <meta name="citation_author_institution" content="Division of Neuroscience" /> <meta name="citation_author_institution" content="University of Manchester" /> <meta name="citation_author" content="Farhat Mirza" /> <meta name="citation_author_institution" content="Manchester Centre for Clinical Neurosciences" /> <meta name="citation_author_institution" content="Salford Royal Hospital" /> <meta name="citation_author" content="Ellen Campbell" /> <meta name="citation_author_institution" content="Department of Neurology" /> <meta name="citation_author_institution" content="Belfast Health and Social Care Trust" /> <meta name="citation_reference" content="citation_journal_title=Obstet Gynaecol;citation_author=N. 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Gopinath;citation_author=AK. Muneer;citation_author=S. Unnikrishnan;citation_title=Children (10-12 years age) of women with epilepsy have lower intelligence, attention and memory: observations from a prospective cohort case control study;citation_pages=58-62;citation_volume=117;citation_year=2015;citation_pmid=26418668" /> <meta name="citation_reference" content="citation_journal_title=JAMA;citation_journal_abbrev=JAMA;citation_author=JM. Reinisch;citation_author=SA. Sanders;citation_author=EL. Mortensen;citation_title=In Utero Exposure to Phenobarbital and Intelligence Deficits in Adult Men;citation_pages=1518-1525;citation_volume=274;citation_year=1995;citation_issue=19;citation_pmid=7474220;citation_doi=10.1001/jama.1995.03530190032031" /> <meta name="twitter:title" content="Preconception counselling in women with epilepsy" /> <meta name="twitter:card" content="summary_large_image" /> <meta name="twitter:image" content="https://pn.bmj.com/sites/default/files/highwire/practneurol/24/6.cover-source.jpg" /> <meta name="twitter:description" content="Pregnancy and the postpartum period are potentially high-risk periods for women with epilepsy and their babies. All women with epilepsy should have the opportunity for preconception counselling with the aim of reducing risk, optimising outcomes for the potentially developing fetus and enabling informed decision-making. This article provides an evidence-based framework for preconception counselling discussion, including the review of diagnosis and of current antiseizure medication, the risk to the fetus in relation to antiseizure medication and maternal seizures, maternal morbidity, SUDEP risk, folic acid supplements, contraception, breastfeeding and safety advice. No data are available." /> <meta name="og-title" property="og:title" content="Preconception counselling in women with epilepsy" /> <meta name="og-url" property="og:url" content="https://pn.bmj.com/content/24/6/478" /> <meta name="og-site-name" property="og:site_name" content="Practical Neurology" /> <meta name="og-description" property="og:description" content="Pregnancy and the postpartum period are potentially high-risk periods for women with epilepsy and their babies. All women with epilepsy should have the opportunity for preconception counselling with the aim of reducing risk, optimising outcomes for the potentially developing fetus and enabling informed decision-making. This article provides an evidence-based framework for preconception counselling discussion, including the review of diagnosis and of current antiseizure medication, the risk to the fetus in relation to antiseizure medication and maternal seizures, maternal morbidity, SUDEP risk, folic acid supplements, contraception, breastfeeding and safety advice. 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class="highwire-cite highwire-cite-highwire-article highwire-citation-bmjj-title clearfix"> <div class="highwire-cite-title">Preconception counselling in women with epilepsy</div> <span class="highwire-cite-access"><span class="highwire-citation-access highwire-citation-access-check" data-pisa-id="practneurol;pn-2023-003902" data-atom-uri="/practneurol/24/6/478.atom" data-request-view="full"></span></span> </cite> </div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-panel-tabs-container col-narrow-12 clear" > <div class="pane-content"> <div data-panels-ajax-tab-preloaded="jnl_template_bmjj_tab_art" id="panels-ajax-tab-container-highwire_article_tabs" class="panels-ajax-tab-container"><div class="panels-ajax-tab-loading" style ="display:none"><img class="loading" src="https://pn.bmj.com/sites/all/modules/contrib/panels_ajax_tab/images/loading.gif" alt="Loading" title="Loading" /></div><div class="panels-ajax-tab-wrap-jnl_template_bmjj_tab_art"><div class="panel-display panel-1col clearfix" > <div class="panel-panel panel-col"> <div><div class="panel-pane pane-highwire-markup author-affiliates col-narrow-12 author-affiliates-corresp article" > <div class="pane-content"> <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div xmlns:xhtml="http://www.w3.org/1999/xhtml" class="contributors"><ol class="contributor-list" id="contrib-group-1"><li class="contributor" id="contrib-1"><a href="http://orcid.org/0000-0001-5018-5494" class="bmjj-markup-orcid-logo" target="_blank">http://orcid.org/0000-0001-5018-5494</a><span class="name">Emily J Pegg</span><a id="xref-aff-1-1" class="xref-aff" href="#aff-1">1</a><span class="xref-sep">,</span><a id="xref-aff-2-1" class="xref-aff" href="#aff-2">2</a>, </li><li class="contributor" id="contrib-2"><span class="name">Rebecca Bromley</span><a id="xref-aff-2-2" class="xref-aff" href="#aff-2">2</a>, </li><li class="contributor" id="contrib-3"><span class="name">Farhat Mirza</span><a id="xref-aff-1-2" class="xref-aff" href="#aff-1">1</a>, </li><li class="last" id="contrib-4"><span class="name">Ellen Campbell</span><a id="xref-aff-3-1" class="xref-aff" href="#aff-3">3</a></li></ol><ol class="affiliation-list"><li class="aff"><a id="aff-1" name="aff-1"></a><address> <sup>1</sup> <span class="institution">Manchester Centre for Clinical Neurosciences</span>, <span class="institution">Salford Royal Hospital</span>, <span class="addr-line">Salford</span>, UK </address></li><li class="aff"><a id="aff-2" name="aff-2"></a><address> <sup>2</sup> <span class="institution">Division of Neuroscience</span>, <span class="institution">University of Manchester</span>, <span class="addr-line">Manchester</span>, UK </address></li><li class="aff"><a id="aff-3" name="aff-3"></a><address> <sup>3</sup> <span class="institution">Department of Neurology</span>, <span class="institution">Belfast Health and Social Care Trust</span>, <span class="addr-line">Belfast</span>, UK </address></li></ol><ol class="corresp-list"><li class="corresp" id="corresp-1"><span class="corresp-label">Correspondence to</span> Dr Emily J Pegg; <span class="em-link"><span class="em-addr">emily-pegg{at}doctors.org.uk</span></span> </li></ol></div></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-markup abstract-with-bc" > <div class="pane-content"> <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" id="content-block" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article abstract-view "><span class="highwire-journal-article-marker-start"></span><div class="section abstract" id="abstract-1"><h2>Abstract</h2><p id="p-1">Pregnancy and the postpartum period are potentially high-risk periods for women with epilepsy and their babies. All women with epilepsy should have the opportunity for preconception counselling with the aim of reducing risk, optimising outcomes for the potentially developing fetus and enabling informed decision-making. This article provides an evidence-based framework for preconception counselling discussion, including the review of diagnosis and of current antiseizure medication, the risk to the fetus in relation to antiseizure medication and maternal seizures, maternal morbidity, SUDEP risk, folic acid supplements, contraception, breastfeeding and safety advice.</p></div><ul class="kwd-group"><li class="kwd">EPILEPSY</li><li class="kwd">ANTICONVULSANTS</li><li class="kwd">OBSTETRICS</li></ul><div class="section data-availability" id="sec-23"><h2 class="">Data availability statement</h2><p id="p-80">No data are available.</p></div><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-dfp-pane oas-ads oas-ads-mid pull-right" > <div class="pane-content"> <div id="dfp-ad-mpu-wrapper" class="dfp-tag-wrapper"> <div id="dfp-ad-mpu" class="dfp-tag-wrapper"> <script type="text/javascript"> googletag.cmd.push(function() { googletag.display("dfp-ad-mpu"); }); </script> </div> </div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-custom pane-1" > <div class="pane-content"> <p><a href="https://doi.org/10.1136/pn-2023-003902" target="_new">https://doi.org/10.1136/pn-2023-003902</a></p> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-altmetrics" > <h2 class="pane-title">Statistics from Altmetric.com</h2> <div class="pane-content"> <div data-badge-details="right" data-badge-type="medium-donut" data-doi="10.1136/pn-2023-003902" data-hide-no-mentions="true" class="altmetric-embed"></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-bmjj-jumplinks" > <div class="pane-content"> <div class="highwire-list-wrapper"><div class="highwire-list"><ul></ul></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-custom pane-2 permissions-box" > <h2 class="pane-title">Request Permissions</h2> <div class="pane-content"> <p>If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.</p> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-panels-ajax-pane-content permissions-box pane-highwire-permission-link" id="request-permissions"> <h2 class="pane-title"><span class='panels-ajax-pane-title' data-pid='new-70fd4c70-563e-4b94-ae3b-2a97f3980c13'></span></h2> <div class="pane-content"> <div class='panels-ajax-pane panels-ajax-pane-new-70fd4c70-563e-4b94-ae3b-2a97f3980c13' data-pid='new-70fd4c70-563e-4b94-ae3b-2a97f3980c13'></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-markup" > <div class="pane-content"> <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article abstract-view "><span class="highwire-journal-article-marker-start"></span><ul class="kwd-group"><li class="kwd"><a href="/keyword/epilepsy" class="hw-term hw-article-keyword hw-article-keyword-epilepsy" rel="nofollow">EPILEPSY</a></li><li class="kwd"><a href="/keyword/anticonvulsants" class="hw-term hw-article-keyword hw-article-keyword-anticonvulsants" rel="nofollow">ANTICONVULSANTS</a></li><li class="kwd"><a href="/keyword/obstetrics" class="hw-term hw-article-keyword hw-article-keyword-obstetrics" rel="nofollow">OBSTETRICS</a></li></ul><div class="section data-availability" id="sec-23"><h2 class="">Data availability statement</h2><p id="p-80">No data are available.</p></div><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="https://pn.bmj.com/content/24/6/478.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-markup footnotes" > <div class="pane-content"> <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div xmlns:xhtml="http://www.w3.org/1999/xhtml" class="section fn-group" id="fn-group-1"><h2>Footnotes</h2><ul><li class="fn-other" id="fn-7"><p id="p-75"><span class="fn-label">Contributors</span> EP initiated the article and took the lead in writing and coordinating the manuscript. 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