Reproductive activity and offspring health of young adults with childhood-onset epilepsy: A controlled study

Purpose: To study reproductive activity and offspring health in a prospective follow-up setting. Methods: After a 35-year follow-up of a population-based patient cohort with childhood-onset ''epilepsy only,'' 100 (56.8%) of 176 surviving patients were shown to have ''epilepsy only'', i.e., recurrent unprovoked seizures with no associated neuroimpairment. Their reproductivity and offspring health were compared with those of matched controls. Results: The marriage rate and fertility of patients with ''epilepsy only'' were significantly reduced as compared with those of matched controls. Continuation of antiepileptic drug (AED) treatment was significantly associated with reduced reproduction, whereas occurrence of seizures during the previous 5 years was not. The incidence of epilepsy was nine times greater among the children of patients than among those of controls. No higher risks were observed in pregnancy or delivery in patients, nor were increased rates of birth defects in their offspring than in those of controls. Exposure to AEDs during pregnancy did not increase these risks. Conclusions: Patients with ''epilepsy only'' since childhood have fewer marriages and fewer children than expected. However, when they marry, their pregnancies and deliveries are unremarkable and their children do not have increased congenital health problems. Obviously, etiologies causative of both epilepsy and associated neurological impairments are more harmful to the course of pregnancy and delivery and offspring health than are those resulting in ''epilepsy only''.