P.020 The North American AED Pregnancy Registry: A Canadian Subgroup Analysis (1997-2019)

Abstract

Background: This study aims to provide data on the care of pregnant women with epilepsy (pWWE) that is directly applicable to the Canadian context. Methods: Between 1997 and 2019, pWWE from Canada and the USA who enrolled into the North American AED Pregnancy Registry (NAARP) completed a questionnaire on their AED (anti-epileptic drug) usage. Enrollment rates to NAARP were compared between the two countries, and between the different Canadian provinces using population-based enrollment rate ratios (PERR). The AED prescription pattern among Canadian pWWE was analysed and compared with the USA. Results: During the study period, 10,215 women enrolled into NAARP : 4.1% (n=419) were Canadian, below the expected population-based contribution (PERR=0.42; p<0.01). Within Canada, the three northern territories (PERR=0; p<0.01), Prince-Edward Island (PERR=0; p<0.01), and Quebec (PERR=0.41; p<0.01) had the lowest enrollment rate ratios. Lamotrigine was the most commonly prescribed AED among canadian pWWE; they were, however, more likely to be on polytherapy (25%; p=0.13), on Carbamazepine (24%; p<0.01) or valproic acid (21%; p<0.01) than their American counterparts. Conclusions: Greater enrollment of Canadian women to NAARP, through enhanced clinician referrals, in particular from underrepresented provinces/territories, could lead to more accurate population-specific data and help identify gaps in the care of this vulnerable patient population.