Abstract
A North American Registry of Epilepsy and Pregnancy has been established as a surveillance mechanism to identify adverse pregnancy outcomes which may be associated with fetal exposure to antiepileptic drugs (AED). As public attitudes become more receptive, and medical management more effective, women with epilepsy (WWE), are choosing parenthood in increasingly larger numbers. In the United States alone there are an estimated 800,000 to 1.1 million women with epilepsy of child bearing age. Previous research has demonstrated that the offspring of these patients have rates of congenital malformations ranging from 1.25 to 11.5%.

There are several factors which could contribute to this risk:
· AED
· Seizures During Gestation
· Maternal Epilepsy

AED are the variable over which we have some control. Unfortunately, there does not exist data which permits physicians to determine the relative safety of specific AED. With the introduction of several new AED none of which has been tested in pregnancy, further uncertainty exists about the potential safety of AED in pregnant patients.

We have developed a prospective registry for pregnant women with epilepsy, which by monitoring systematically their pregnancy can serve as an early warning system for adverse outcomes associated with the specific AED alone or in combination. This has required a cooperative effort between the scientific and pharmaceutical communities. The genesis of this effort is described.

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