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Preconception counselling in women with epilepsy
  1. Emily J Pegg1,2,
  2. Rebeccca Bromley3,
  3. Farhat Mirza1,
  4. Ellen Campbell4
  1. 1Manchester Centre for Clinical Neurosciences, Salford Royal Hospital, Salford, UK
  2. 2Division of Neuroscience, University of Manchester, Manchester, UK
  3. 3Department of Neuroscience, University of Manchester, Manchester, UK
  4. 4Department of Neurology, Belfast Health and Social Care Trust, Belfast, UK
  1. Correspondence to Dr Emily J Pegg, Salford Royal Hospital Manchester Centre for Clinical Neurosciences, Salford, Greater Manchester, UK; emily-pegg{at}


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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  • Contributors EP initiated the article and took the lead in writing and coordinating the manuscript. All authors contributed to writing individual sections and reviewed the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests RB has provided consultancy to a women’s health initiative funded by UCB Pharma with the fee going to her institution.

  • Provenance and peer review Provenance and peer review. Commissioned. Externally peer reviewed by Lina Nashef, London, UK.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.