Folic acid supplementation in women of childbearing age with epilepsy: No association with type or number of antiepileptic drugs

Background: For over two decades, a daily folic acid (FA) supplementation has been recommended for women of childbearing age with epilepsy. This recommendation is based on evidence that FA administration before conception and during pregnancy can decrease the risk of fetal malformations in the general population, improve cognitive development, and reduce the risk of autistic traits in children exposed in utero to antiepileptic drugs (AEDs).Objective: The aim of this study was to evaluate FA supplementation rate in nonpregnant women of childbearing age with epilepsy and its relation to AED type and number.Methods: We retrospectively reviewed the computerized database and the medical records of all the women who had a first visit to our outpatient epilepsy clinic (Shamir-Assaf Harofeh Medical Center, Zerifin, Israel) during a 10-year period (2012-2021).Results: Only 61 (22%) of 282 nonpregnant women of childbearing age with epilepsy treated with AEDs received FA supplementation. Ninety-two (33%) of the women were treated with AED polytherapy, and 41 (15%) received valproic acid in monotherapy or polytherapy. FA supplementation rate was higher in women aged <= 40 versus >40 (25% vs. 8.5%) (p = .004). No correlation was found between FA supplementation and AED type or number.Conclusions: FA supplementation rate was low and was unaffected by AED treatment. Patient and physician-targeted interventions should be implemented to increase FA prescription and patient adherence.

Automated summary

This study evaluated the rate of folic acid supplementation in nonpregnant women of childbearing age with epilepsy and its relation to the type and number of antiepileptic drugs (AEDs) used. The results showed that the rate of folic acid supplementation was low and unaffected by AED treatment. Patient and physician-targeted interventions are needed to increase folic acid prescription and patient adherence.