Since its establishment in 1999 by a dedicated team led by Prof. Frank Vajda, the Australian Pregnancy Register has been an essential resource for understanding the effects of antiseizure medications on pregnant women with epilepsy. Prof. Terry O’Brien, Prof. Cecilie Lander, Janet Graham, Alison Hitchcock, Emeritus Prof. Mervyn Eadie, and Prof. Piero Perucca have also played key roles in this ground-breaking longitudinal study, which has provided critical insights into the risk of foetal malformations associated with different antiseizure medications, shaping prescribing practices within the healthcare community.
For many years, Epilepsy Action Australia has been the primary financial supporter of the Australian Pregnancy Register, ensuring the continuation of its vital research and impact.
Data from over 2,500 pregnancies indicate that nearly half were referred by neurologists, while many women self-enrolled to participate. Notably, about 8% of these pregnancies involved no antiseizure medications during the crucial early months, serving as a valuable comparison group.
As evidence of the risks associated with valproate emerged, the Australian Pregnancy Register closely monitored how decreasing its use would affect the incidence of foetal malformations and whether seizure control could be maintained with newer medications. They found that valproate teratogenicity is strongly dose related. A significant outcome of this research is the change in clinical practice and a substantial reduction in the average daily dose of valproate among pregnant women, which has decreased by about two-thirds. This reduction correlates with a decline in the overall rate of pregnancies with foetal malformations. While serious conditions like spina bifida appear to be less common, some less severe issues may have increased.
A noteworthy finding of the Australian Pregnancy Register reveals that seizure freedom in the year preceding pregnancy is a strong predictor of seizure-free outcomes during and after pregnancy.
As more women experience pregnancies free from seizures, the Australian Pregnancy Register continues to be instrumental in advancing our understanding of epilepsy management during pregnancy and guiding safer healthcare practices, all thanks to the vision and leadership of its founders and contributors.
Click here to find out more about the Australian Pregnancy Register or go to Australian Pregnancy Register Registration – Epilepsy Action Australia to register.
Contact Australian Pregnancy Register on 1800 069 722 or email them at [email protected]
