Connors-BRI Symposium

Incorporating Sex as Biologic Variable to Advance Health

May 24, 2021 | 3-5PM

Virtual Event

Mallika Purandare, BS

Brigham and Women’s Hospital


Introduction: Sex hormone fluctuations are known to affect the neurobiology of epilepsy and mood disorders. We hypothesize that women with epilepsy (WWE) who experience seizures postpartum have a higher risk of postpartum depression (PPD). We chose WWE on lamotrigine, a commonly prescribed antiseizure medications during pregnancy, with known mood-stabilizing effects.

Methods: We included all WWE on lamotrigine monotherapy followed at BWH Epilepsy-Obstetric clinics from 2018-2020. Clinical data on seizure types and frequency was collected in a longitudinal prospective database. Additional information on Edinburgh Postnatal Depression Score (EPDS) at 6-weeks postpartum, medical, and surgical history was obtained through chart review. We utilized univariate and multivariate logistic regression analysis to compare variables of interest between women with different EPDS scores.

Results: 31 WWE met inclusion criteria; mean age was 35 years and 87% (n = 27) were white. EPDS data is as follows: 74% (n=23) women had minimal depression, 10% (n=3) women had mild depression, 13% (n=4) had moderate depression, and 3% (n=1) had severe depression. 20 women remained seizure-free throughout pregnancy and postpartum; 11 were refractory. PPD was identified in 18% (n=2) of women with refractory epilepsy and 20% (n=4) of seizure-free women. Multivariate regression analysis demonstrated that prior history of depression was significantly correlated with poorer EPDS scores (p = 0.024), while other factors tested (age, epilepsy type, seizure freedom, seizure frequency changes) were insignificant.

Conclusion: Results suggest that history of depression is associated with a higher risk of depressed mood in early postpartum WWE. Seizure occurrence during postpartum period did not have a strong correlation with a depressed mood in our small cohort. Future studies may benefit from comparing WWE on lamotrigine to WWE on other antiseizure medications to clarify the role of lamotrigine for seizure control and mood stabilization in this cohort.


3PM – Welcome Remarks
3:05PM – Keynote Address
3:45PM – Featured Short Talks
4:20PM – Lightning Talks
4:50PM – Closing Remarks

Keynote Speaker

Janine Austin Clayton, MD

Janine Austin Clayton, M.D., Associate Director for Research on Women’s Health and Director of the Office of Research on Women’s Health (ORWH) at the National Institutes of Health (NIH), is the architect of the NIH policy requiring scientists to consider sex as a biological variable across the research spectrum. This policy is part of NIH’s initiative to enhance reproducibility through rigor and transparency. As co-chair of the NIH Working Group on Women in Biomedical Careers with NIH Director Dr. Francis Collins, Dr. Clayton also leads NIH’s efforts to advance women in science careers.

Prior to joining the ORWH, Dr. Clayton was the Deputy Clinical Director of the National Eye Institute (NEI) for seven years. A board-certified ophthalmologist, Dr. Clayton’s research interests include autoimmune ocular diseases and the role of sex and gender in health and disease. She is the author of more than 120 scientific publications, journal articles, and book chapters.
Dr. Clayton, a native Washingtonian, received her undergraduate degree with honors from Johns Hopkins University and her medical degree from Howard University College of Medicine. She completed a residency in ophthalmology at the Medical College of Virginia. Dr. Clayton completed fellowship training in cornea and external disease at the Wilmer Eye Institute at Johns Hopkins Hospital and in uveitis and ocular immunology at NEI.

Dr. Clayton has received numerous awards, including the Senior Achievement Award from the Board of Trustees of the American Academy of Ophthalmology in 2008 and the European Uveitis Patient Interest Association Clinical Uveitis Research Award in 2010. She was selected as a 2010 Silver Fellow by the Association for Research in Vision and Ophthalmology. In 2015, she was awarded the American Medical Women’s Association Lila A. Wallis Women’s Health Award and the Wenger Award for Excellence in Public Service. Dr. Clayton was granted the Bernadine Healy Award for Visionary Leadership in Women’s Health in 2016. She was also selected as an honoree for the Woman’s Day Red Dress Awards and the American Medical Association’s Dr. Nathan Davis Awards for Outstanding Government Service in 2017.