T Lavi-Blau, D Ekstein, MY Neufeld, S Eyal.  Epilepsy & Behavior 55 (2016) 113–119.

Purpose

Pregnant or breastfeeding women with epilepsy may be concerned about the effects of pregnancy on their seizures or the effects of medications on their child. The vast majority of women and babies in this situation do very well. It is important that women receive accurate information about this topic. Surveys among women with epilepsy show that they receive their essential pregnancy-related information from many sources, including the Internet.

Description of Study

This article assessed the types of websites provided by a Google search for the use of four seizure medications used during pregnancy and breastfeeding.

The search was performed on:

  • 40 computers used by health care professionals
  • 40 computers used by non-healthcare professionals
  • 5 computers used by women with epilepsy in Israel (where the main authors are located)
  • 8 computers used by nonhealth-care professionals in the U.S.

On each computer, a Google search was conducted for combinations of terms that included two older medications (“carbamazepine” and “valproic acid”), two newer medications (“lamotrigine” and “levetiracetam”), and the brand name of one of them (“Keppra”), as well as “pregnancy,” “lactation,” or “breastfeeding.” The top websites retrieved in every search were mapped.

Summary of Study Findings

  1. For searches in English, the majority of websites listed among the first three and first 10 results were those of independent health portals rather than governmental or advocacy organizations.
  2. The Epilepsy Foundation website represented 10% or less of results, and only a few results were obtained from the National Institutes of Health’s (NIH's) general public-oriented site, MedlinePlus.
  3. In Hebrew, as in English, results from public-oriented, professionally-written websites in Hebrew accounted for less than 50% of entries.

What does this mean?

  • The availability of readable and high-quality information on common seizure medications used by pregnant and breastfeeding women is limited. When women and healthcare providers are left to search these terms on their own, they are likely to encounter websites that do not necessarily provide the information they are looking for.
  • Guiding people towards accurate web resources can help them navigate among the huge amount of online information. People with epilepsy should ask their healthcare provider specific questions about issues related to women and also ask to be guided to high quality websites.
  • Healthcare providers should more actively discuss pregnancy and breastfeeding issues with women of childbearing age and direct them to accurate available information.  

Article published in Epilepsy & Behavior, February 2016

Authored By: 
Nathan B. Fountain MD
Authored Date: 
02/2016