Background: This study aims to provide data on
the care of pregnant women with epilepsy (pWWE) that is directly applicable
to the Canadian context. Methods: Between 1997 and
2019, pWWE from Canada and the USA who enrolled into the North American AED
Pregnancy Registry (NAARP) completed a questionnaire on their AED
(anti-epileptic drug) usage. Enrollment rates to NAARP were compared between
the two countries, and between the different Canadian provinces using
population-based enrollment rate ratios (PERR). The AED prescription pattern
among Canadian pWWE was analysed and compared with the USA.
Results: During the study period, 10,215 women
enrolled into NAARP : 4.1% (n=419) were Canadian, below the expected
population-based contribution (PERR=0.42; p<0.01). Within Canada, the
three northern territories (PERR=0; p<0.01), Prince-Edward Island
(PERR=0; p<0.01), and Quebec (PERR=0.41; p<0.01) had the lowest
enrollment rate ratios. Lamotrigine was the most commonly prescribed AED
among canadian pWWE; they were, however, more likely to be on polytherapy
(25%; p=0.13), on Carbamazepine (24%; p<0.01)
or valproic acid (21%; p<0.01) than their
American counterparts. Conclusions: Greater
enrollment of Canadian women to NAARP, through enhanced clinician referrals,
in particular from underrepresented provinces/territories, could lead to
more accurate population-specific data and help identify gaps in the care of
this vulnerable patient population.
Malformation risk of antiepileptic drug exposure during pregnancy in women with epilepsy: Results from a pregnancy registry in South India