Pregnancy outcomes in women with epilepsy and MTHFR mutations supplemented with methylated folate and methylcobalamin (methylated B12)

Emma M Lascar; Nicole M Warner; Michael J Doherty

doi:10.1016/j.ebr.2020.100419

Pregnancy outcomes in women with epilepsy and MTHFR mutations supplemented with methylated folate and methylcobalamin (methylated B12)

Epilepsy Behav Rep. 2020 Dec 17:15:100419. doi: 10.1016/j.ebr.2020.100419. eCollection 2021.

Authors

Emma M Lascar^{1

2}, Nicole M Warner², Michael J Doherty²

Affiliations

¹ Department of Neuroscience, University of Washington, 1953 Pacific Ave, Seattle, WA, USA.
² Swedish Epilepsy Center, Swedish Hospital, Seattle, WA, USA.

Abstract

Antiseizure medications (ASM) may contribute to adverse fetal outcomes in pregnant women with epilepsy (WWE). Folate processing (Methylenetetrahydrofolate reductase, MTHFR) gene abnormalities are common in women with epilepsy and depression. L-methylfolate supplements may bypass MTHFR deficiencies, yet their use in WWE during gestation or on fetal development is not well studied. We examine pregnancy histories of three WWE who supplemented with either folate or L-methylfolate and methylcobalamin (methylated B12) during pregnancies. Their pregnancy outcomes improved with L-methylfolate and methylcobalamin supplementation. L-methylfolate and methylcobalamin supplementation merits further study in WWE who have MTHFR mutations, fertility, recurrent miscarriage and or depression histories.

Keywords: ASD, Autism spectrum disorder; ASM, Antiseizure medication; B-12; Fetal; MTHFR, Methylenetetrahydrofolate reductase; Neural tube defect; Pregnancy; Vitamin; WWE, women with epilepsy.