Reader response: Unintended pregnancy, prenatal care, new-born outcomes, and breastfeeding in women with epilepsy

Alain Braillon, Senior Consultant, University Hospital. 80000 Amiens. (Amiens, France)

Susan Bewley, Pr., King’s College (London, UK)

Published August 19, 2019

Pennell and Meador rightly expressed concern about reducing birth defects in women with epilepsy with their editorial endorsing the EURAP registry (a prospective registry of women with epilepsy on AEDs, involving 42 countries across 4 continents).1,2 However, this was a missed opportunity to acknowledge the role of patients in better decision-making processes in regulatory activities.3

The over-long history of the devastating consequences of valproate prescription during pregnancy illuminates a broken system. The first series of valproate-related congenital malformations was published in the Lancet as far back as 1982.4 However, the first prescription restriction wasn’t issued until May 2015 by the French Medicines Agency. This coincided with a legal case going public in France, thanks to Marine Martin, a mother whose two consecutive children were damaged and who created an umbrella association for the prosecution.5