Folate use in women with epilepsy: Predictors of adherence in a specialized tertiary outclinic

Adherence of Saudi women with epilepsy to folic acid intake in the preconceptional period in two tertiary care hospitals in Riyadh: A cross sectional study

“…This disparity in the results between our study and previous studies in the same country possibly reflects a greater concern among women with epilepsy regarding congenital anomalies that are linked to ASMs and therefore a greater motivation for compliance with folic acid intake. However, the adherence rate in our cohort was also higher than the reported rate in international studies done in China (29.1%) and Brazil (42.4%) among WWE [12] , [13] . Because the sample came from tertiary medical centers and the subjects were followed in specialized epilepsy clinics, sampling bias might have contributed to this relatively high adherence rate.…”

“…One study conducted in China showed that 35.3% of pregnant women with epilepsy had never taken folic acid, and less than one-third of the study sample started taking folic acid before conception [12] . Another study conducted in Brazil showed an adherence rate of 42% for folate supplementation in WWE [13] . The Epilepsy Birth Control Registry (EBCR) indicated a prevalence of 46.7% for folic acid use among WWE [14] .…”

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

“…Higher rates (82% and 88%) were reported with preconception care and following interventions that increased physician and patient awareness of the guidelines, adherence to pregnancy counseling during outpatient visits, and electronic reminders of FA prescription in women of childbearing age with epilepsy on AEDs (Baishya et al, 2020; Keni et al, 2020; Patel et al, 2018). Low FA supplementation rates were related to low rates of pregnancy counseling and FA prescription nonadherence, and were associated with specific clinical and demographic variables such as planned pregnancy, contraceptive method, education level, race, income, employment, and area of living (urban vs. rural in a developing country) (Herzog et al, 2017; Ishikawa et al, 2020; Minshall & Neligan, 2014; Moura et al, 2015; Passarelli et al, 2015). According to Herzog et al (2017), AED use was found to be a significant predictor of FA use by women with epilepsy overall.…”

“…FA supplementation rate was significantly higher in women aged ≤40 years, probably because pregnancy was deemed more likely in this age group compared to older women by their physicians, an assumption supported by data suggesting that maternal age at delivery was ≤40 years in ≥95% of the deliveries in Israel during the study period (Ministry of Health, 2021). Despite accumulating evidence and treatment guidelines published for over two decades, FA supplementation rates continue to be low worldwide (Hao et al, 2015; Herzog et al, 2017; Ishikawa et al, 2020; Minshall & Neligan, 2014; Moura et al, 2015; Passarelli et al, 2015). According to studies published in the past decade, preconceptional FA supplementation rates in women of childbearing age with epilepsy, including adolescent women, range between 9% and 52% (Hao et al, 2015; Herzog et al, 2017; Ishikawa et al, 2020; Minshall & Neligan, 2014; Moura et al, 2015; Passarelli et al, 2015; Petersen et al, 2019).…”

“…Despite accumulating evidence and treatment guidelines published for over two decades, FA supplementation rates continue to be low worldwide (Hao et al, 2015; Herzog et al, 2017; Ishikawa et al, 2020; Minshall & Neligan, 2014; Moura et al, 2015; Passarelli et al, 2015). According to studies published in the past decade, preconceptional FA supplementation rates in women of childbearing age with epilepsy, including adolescent women, range between 9% and 52% (Hao et al, 2015; Herzog et al, 2017; Ishikawa et al, 2020; Minshall & Neligan, 2014; Moura et al, 2015; Passarelli et al, 2015; Petersen et al, 2019). Higher rates (82% and 88%) were reported with preconception care and following interventions that increased physician and patient awareness of the guidelines, adherence to pregnancy counseling during outpatient visits, and electronic reminders of FA prescription in women of childbearing age with epilepsy on AEDs (Baishya et al, 2020; Keni et al, 2020; Patel et al, 2018).…”