Evidence map›Paper›PMID 33369356›Full record

Observational studyThe New England journal of medicine2020

Changes in Seizure Frequency and Antiepileptic Therapy during Pregnancy.

Page B Pennell, Jacqueline A French, Ryan C May, Elizabeth Gerard, Laura Kalayjian, Patricia Penovich, Evan Gedzelman, Jennifer Cavitt, Sean Hwang, Alison M Pack and 7 more

2 registry-linked trialsOpen access · bronzeAbstract readComparative StudyMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The New England journal of medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 43 papers.

0numbers the graph read from it
0cells of the map it votes in
43citing papers in PubMed
17.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01730170 completednot on this map

Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs

TypeobservationalSponsorStanford UniversityRan2013 to 2022Enrolled565ConditionsEpilepsy, Pregnancy
NCT05450978 recruitingnot on this mapstarted 2022, after this paper: background citation

Physiological-based Pharmacokinetics Approach to Determine the Extent of Drug Exposure of Antiseizure Medications During Pregnancy and Breastfeeding

Typeobservational_patient_registrySponsorUniversity of PittsburghRan2022 to 2028Enrolled60ConditionsEpilepsy, Pregnancy RelatedArmsLamotrigine, Levetiracetam, Oxcarbazepine
3 · Its place in the literature

Who cites it

43 citing papers in PubMed, 107 citations in OpenAlex.

  1. Article
  2. Review
  3. Observational
  4. Article
  5. Article
  6. Review
  7. Observational
  8. Observational
  9. Article
  10. Article
  11. Article
  12. Epilepsy in women of childbearing age: a focused review.Neurological research and practice · 2025
    Review
  13. Article
  14. Review
  15. Review
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors at 7 institutions in 2 countries.

Page B PennellFrom Brigham and Women's Hospital, Harvard Medical School, Boston (P.B.P.); New York University Comprehensive Epilepsy Center (J.A.F.) and Columbia University (A.M.P.), New York, and Northwell Health, Great Neck (S.H.) - both in New York; Emmes, Rockville, MD (R.C.M., S.H.W., C.B.); Northwestern University, Chicago (E. Gerard); the University of Southern California, Los Angeles (L.K.), and Stanford University, Palo Alto (K.J.M.) - both in California; the Minnesota Epilepsy Group, St. Paul (P.P.), and the University of Minnesota, Minneapolis (A.K.B.); Emory University School of Medicine, Atlanta (E. Gedzelman); the University of Cincinnati, Cincinnati (J.C.); Wake Forest University, Winston-Salem, NC (M.S.); and the University of Washington, Seattle (J.W.M.).ORCID 0000-0003-0568-2795
Jacqueline A FrenchFrom Brigham and Women's Hospital, Harvard Medical School, Boston (P.B.P.); New York University Comprehensive Epilepsy Center (J.A.F.) and Columbia University (A.M.P.), New York, and Northwell Health, Great Neck (S.H.) - both in New York; Emmes, Rockville, MD (R.C.M., S.H.W., C.B.); Northwestern University, Chicago (E. Gerard); the University of Southern California, Los Angeles (L.K.), and Stanford University, Palo Alto (K.J.M.) - both in California; the Minnesota Epilepsy Group, St. Paul (P.P.), and the University of Minnesota, Minneapolis (A.K.B.); Emory University School of Medicine, Atlanta (E. Gedzelman); the University of Cincinnati, Cincinnati (J.C.); Wake Forest University, Winston-Salem, NC (M.S.); and the University of Washington, Seattle (J.W.M.).
Ryan C MayFrom Brigham and Women's Hospital, Harvard Medical School, Boston (P.B.P.); New York University Comprehensive Epilepsy Center (J.A.F.) and Columbia University (A.M.P.), New York, and Northwell Health, Great Neck (S.H.) - both in New York; Emmes, Rockville, MD (R.C.M., S.H.W., C.B.); Northwestern University, Chicago (E. Gerard); the University of Southern California, Los Angeles (L.K.), and Stanford University, Palo Alto (K.J.M.) - both in California; the Minnesota Epilepsy Group, St. Paul (P.P.), and the University of Minnesota, Minneapolis (A.K.B.); Emory University School of Medicine, Atlanta (E. Gedzelman); the University of Cincinnati, Cincinnati (J.C.); Wake Forest University, Winston-Salem, NC (M.S.); and the University of Washington, Seattle (J.W.M.).
Elizabeth GerardFrom Brigham and Women's Hospital, Harvard Medical School, Boston (P.B.P.); New York University Comprehensive Epilepsy Center (J.A.F.) and Columbia University (A.M.P.), New York, and Northwell Health, Great Neck (S.H.) - both in New York; Emmes, Rockville, MD (R.C.M., S.H.W., C.B.); Northwestern University, Chicago (E. Gerard); the University of Southern California, Los Angeles (L.K.), and Stanford University, Palo Alto (K.J.M.) - both in California; the Minnesota Epilepsy Group, St. Paul (P.P.), and the University of Minnesota, Minneapolis (A.K.B.); Emory University School of Medicine, Atlanta (E. Gedzelman); the University of Cincinnati, Cincinnati (J.C.); Wake Forest University, Winston-Salem, NC (M.S.); and the University of Washington, Seattle (J.W.M.).
Laura KalayjianFrom Brigham and Women's Hospital, Harvard Medical School, Boston (P.B.P.); New York University Comprehensive Epilepsy Center (J.A.F.) and Columbia University (A.M.P.), New York, and Northwell Health, Great Neck (S.H.) - both in New York; Emmes, Rockville, MD (R.C.M., S.H.W., C.B.); Northwestern University, Chicago (E. Gerard); the University of Southern California, Los Angeles (L.K.), and Stanford University, Palo Alto (K.J.M.) - both in California; the Minnesota Epilepsy Group, St. Paul (P.P.), and the University of Minnesota, Minneapolis (A.K.B.); Emory University School of Medicine, Atlanta (E. Gedzelman); the University of Cincinnati, Cincinnati (J.C.); Wake Forest University, Winston-Salem, NC (M.S.); and the University of Washington, Seattle (J.W.M.).
Patricia PenovichFrom Brigham and Women's Hospital, Harvard Medical School, Boston (P.B.P.); New York University Comprehensive Epilepsy Center (J.A.F.) and Columbia University (A.M.P.), New York, and Northwell Health, Great Neck (S.H.) - both in New York; Emmes, Rockville, MD (R.C.M., S.H.W., C.B.); Northwestern University, Chicago (E. Gerard); the University of Southern California, Los Angeles (L.K.), and Stanford University, Palo Alto (K.J.M.) - both in California; the Minnesota Epilepsy Group, St. Paul (P.P.), and the University of Minnesota, Minneapolis (A.K.B.); Emory University School of Medicine, Atlanta (E. Gedzelman); the University of Cincinnati, Cincinnati (J.C.); Wake Forest University, Winston-Salem, NC (M.S.); and the University of Washington, Seattle (J.W.M.).
Evan GedzelmanFrom Brigham and Women's Hospital, Harvard Medical School, Boston (P.B.P.); New York University Comprehensive Epilepsy Center (J.A.F.) and Columbia University (A.M.P.), New York, and Northwell Health, Great Neck (S.H.) - both in New York; Emmes, Rockville, MD (R.C.M., S.H.W., C.B.); Northwestern University, Chicago (E. Gerard); the University of Southern California, Los Angeles (L.K.), and Stanford University, Palo Alto (K.J.M.) - both in California; the Minnesota Epilepsy Group, St. Paul (P.P.), and the University of Minnesota, Minneapolis (A.K.B.); Emory University School of Medicine, Atlanta (E. Gedzelman); the University of Cincinnati, Cincinnati (J.C.); Wake Forest University, Winston-Salem, NC (M.S.); and the University of Washington, Seattle (J.W.M.).
Jennifer CavittFrom Brigham and Women's Hospital, Harvard Medical School, Boston (P.B.P.); New York University Comprehensive Epilepsy Center (J.A.F.) and Columbia University (A.M.P.), New York, and Northwell Health, Great Neck (S.H.) - both in New York; Emmes, Rockville, MD (R.C.M., S.H.W., C.B.); Northwestern University, Chicago (E. Gerard); the University of Southern California, Los Angeles (L.K.), and Stanford University, Palo Alto (K.J.M.) - both in California; the Minnesota Epilepsy Group, St. Paul (P.P.), and the University of Minnesota, Minneapolis (A.K.B.); Emory University School of Medicine, Atlanta (E. Gedzelman); the University of Cincinnati, Cincinnati (J.C.); Wake Forest University, Winston-Salem, NC (M.S.); and the University of Washington, Seattle (J.W.M.).
Sean HwangFrom Brigham and Women's Hospital, Harvard Medical School, Boston (P.B.P.); New York University Comprehensive Epilepsy Center (J.A.F.) and Columbia University (A.M.P.), New York, and Northwell Health, Great Neck (S.H.) - both in New York; Emmes, Rockville, MD (R.C.M., S.H.W., C.B.); Northwestern University, Chicago (E. Gerard); the University of Southern California, Los Angeles (L.K.), and Stanford University, Palo Alto (K.J.M.) - both in California; the Minnesota Epilepsy Group, St. Paul (P.P.), and the University of Minnesota, Minneapolis (A.K.B.); Emory University School of Medicine, Atlanta (E. Gedzelman); the University of Cincinnati, Cincinnati (J.C.); Wake Forest University, Winston-Salem, NC (M.S.); and the University of Washington, Seattle (J.W.M.).ORCID 0000-0002-7004-6464
Alison M PackFrom Brigham and Women's Hospital, Harvard Medical School, Boston (P.B.P.); New York University Comprehensive Epilepsy Center (J.A.F.) and Columbia University (A.M.P.), New York, and Northwell Health, Great Neck (S.H.) - both in New York; Emmes, Rockville, MD (R.C.M., S.H.W., C.B.); Northwestern University, Chicago (E. Gerard); the University of Southern California, Los Angeles (L.K.), and Stanford University, Palo Alto (K.J.M.) - both in California; the Minnesota Epilepsy Group, St. Paul (P.P.), and the University of Minnesota, Minneapolis (A.K.B.); Emory University School of Medicine, Atlanta (E. Gedzelman); the University of Cincinnati, Cincinnati (J.C.); Wake Forest University, Winston-Salem, NC (M.S.); and the University of Washington, Seattle (J.W.M.).
Maria SamFrom Brigham and Women's Hospital, Harvard Medical School, Boston (P.B.P.); New York University Comprehensive Epilepsy Center (J.A.F.) and Columbia University (A.M.P.), New York, and Northwell Health, Great Neck (S.H.) - both in New York; Emmes, Rockville, MD (R.C.M., S.H.W., C.B.); Northwestern University, Chicago (E. Gerard); the University of Southern California, Los Angeles (L.K.), and Stanford University, Palo Alto (K.J.M.) - both in California; the Minnesota Epilepsy Group, St. Paul (P.P.), and the University of Minnesota, Minneapolis (A.K.B.); Emory University School of Medicine, Atlanta (E. Gedzelman); the University of Cincinnati, Cincinnati (J.C.); Wake Forest University, Winston-Salem, NC (M.S.); and the University of Washington, Seattle (J.W.M.).
John W MillerFrom Brigham and Women's Hospital, Harvard Medical School, Boston (P.B.P.); New York University Comprehensive Epilepsy Center (J.A.F.) and Columbia University (A.M.P.), New York, and Northwell Health, Great Neck (S.H.) - both in New York; Emmes, Rockville, MD (R.C.M., S.H.W., C.B.); Northwestern University, Chicago (E. Gerard); the University of Southern California, Los Angeles (L.K.), and Stanford University, Palo Alto (K.J.M.) - both in California; the Minnesota Epilepsy Group, St. Paul (P.P.), and the University of Minnesota, Minneapolis (A.K.B.); Emory University School of Medicine, Atlanta (E. Gedzelman); the University of Cincinnati, Cincinnati (J.C.); Wake Forest University, Winston-Salem, NC (M.S.); and the University of Washington, Seattle (J.W.M.).
Steffanie H WilsonFrom Brigham and Women's Hospital, Harvard Medical School, Boston (P.B.P.); New York University Comprehensive Epilepsy Center (J.A.F.) and Columbia University (A.M.P.), New York, and Northwell Health, Great Neck (S.H.) - both in New York; Emmes, Rockville, MD (R.C.M., S.H.W., C.B.); Northwestern University, Chicago (E. Gerard); the University of Southern California, Los Angeles (L.K.), and Stanford University, Palo Alto (K.J.M.) - both in California; the Minnesota Epilepsy Group, St. Paul (P.P.), and the University of Minnesota, Minneapolis (A.K.B.); Emory University School of Medicine, Atlanta (E. Gedzelman); the University of Cincinnati, Cincinnati (J.C.); Wake Forest University, Winston-Salem, NC (M.S.); and the University of Washington, Seattle (J.W.M.).
Carrie BrownFrom Brigham and Women's Hospital, Harvard Medical School, Boston (P.B.P.); New York University Comprehensive Epilepsy Center (J.A.F.) and Columbia University (A.M.P.), New York, and Northwell Health, Great Neck (S.H.) - both in New York; Emmes, Rockville, MD (R.C.M., S.H.W., C.B.); Northwestern University, Chicago (E. Gerard); the University of Southern California, Los Angeles (L.K.), and Stanford University, Palo Alto (K.J.M.) - both in California; the Minnesota Epilepsy Group, St. Paul (P.P.), and the University of Minnesota, Minneapolis (A.K.B.); Emory University School of Medicine, Atlanta (E. Gedzelman); the University of Cincinnati, Cincinnati (J.C.); Wake Forest University, Winston-Salem, NC (M.S.); and the University of Washington, Seattle (J.W.M.).
Angela K BirnbaumFrom Brigham and Women's Hospital, Harvard Medical School, Boston (P.B.P.); New York University Comprehensive Epilepsy Center (J.A.F.) and Columbia University (A.M.P.), New York, and Northwell Health, Great Neck (S.H.) - both in New York; Emmes, Rockville, MD (R.C.M., S.H.W., C.B.); Northwestern University, Chicago (E. Gerard); the University of Southern California, Los Angeles (L.K.), and Stanford University, Palo Alto (K.J.M.) - both in California; the Minnesota Epilepsy Group, St. Paul (P.P.), and the University of Minnesota, Minneapolis (A.K.B.); Emory University School of Medicine, Atlanta (E. Gedzelman); the University of Cincinnati, Cincinnati (J.C.); Wake Forest University, Winston-Salem, NC (M.S.); and the University of Washington, Seattle (J.W.M.).
Kimford J MeadorFrom Brigham and Women's Hospital, Harvard Medical School, Boston (P.B.P.); New York University Comprehensive Epilepsy Center (J.A.F.) and Columbia University (A.M.P.), New York, and Northwell Health, Great Neck (S.H.) - both in New York; Emmes, Rockville, MD (R.C.M., S.H.W., C.B.); Northwestern University, Chicago (E. Gerard); the University of Southern California, Los Angeles (L.K.), and Stanford University, Palo Alto (K.J.M.) - both in California; the Minnesota Epilepsy Group, St. Paul (P.P.), and the University of Minnesota, Minneapolis (A.K.B.); Emory University School of Medicine, Atlanta (E. Gedzelman); the University of Cincinnati, Cincinnati (J.C.); Wake Forest University, Winston-Salem, NC (M.S.); and the University of Washington, Seattle (J.W.M.).
MONEAD Study Group
Columbia University Irving Medical Center · USBrigham and Women's Hospital · USEmory University · USNorthwell Health · USPalo Alto University · USUniversity of Southern California · USUniversity of Washington · US

Funding

Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD)U01NS038455 · NINDS · STANFORD UNIVERSITY · PI MATTHEWS, ABIGAIL GOREN, MEADOR, KIMFORD J · 2012 to 2022
$27.7M
MONEAD Data and Statistical CenterU01NS050659 · NINDS · THE EMMES COMPANY, LLC · PI MAY, RYAN · 2012 to 2016
$3.5M
Eunice Kennedy Shriver National Institute of Child Health and Human Development U01-NS03845Eunice Kennedy Shriver National Institute of Child Health and Human Development U01-NS050659NINDS NIH HHS U01-NS03845NINDS NIH HHS U01 NS038455NINDS NIH HHS U01 NS050659NINDS NIH HHS U01-NS050659
6 · The paper itself

Abstract

backgroundAmong women with epilepsy, studies regarding changes in seizure frequency during pregnancy have been limited by the lack of an appropriate nonpregnant comparator group to provide data on the natural course of seizure frequency in both groups.

methodsIn this prospective, observational, multicenter cohort study, we compared the frequency of seizures during pregnancy through the peripartum period (the first 6 weeks after birth) (epoch 1) with the frequency during the postpartum period (the following 7.5 months after pregnancy) (epoch 2). Nonpregnant women with epilepsy were enrolled as controls and had similar follow-up during an 18-month period. The primary outcome was the percentage of women who had a higher frequency of seizures that impaired awareness during epoch 1 than during epoch 2. We also compared changes in the doses of antiepileptic drugs that were administered in the two groups during the first 9 months of epoch 1.

resultsWe enrolled 351 pregnant women and 109 controls with epilepsy. Among the 299 pregnant women and 93 controls who had a history of seizures that impaired awareness and who had available data for the two epochs, seizure frequency was higher during epoch 1 than during epoch 2 in 70 pregnant women (23%) and in 23 controls (25%) (odds ratio, 0.93; 95% confidence interval [CI], 0.54 to 1.60). During pregnancy, the dose of an antiepileptic drug was changed at least once in 74% of pregnant women and in 31% of controls (odds ratio, 6.36; 95% CI, 3.82 to 10.59).

conclusionsAmong women with epilepsy, the percentage who had a higher incidence of seizures during pregnancy than during the postpartum period was similar to that in women who were not pregnant during the corresponding epochs. Changes in doses of antiepileptic drugs occurred more frequently in pregnant women than in nonpregnant women during similar time periods. (Funded by the National Institutes of Health; MONEAD ClinicalTrials.gov number, NCT01730170.).

Indexed as

AdultAnticonvulsantsEpilepsyFemaleHumansIncidencePostpartum PeriodPregnancyPregnancy ComplicationsProspective StudiesSeizuresAnticonvulsants

Identifiers

PMID33369356
PMCPMC7919187
OpenAlexW3113620641

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.