Summary:Purpose: Women with epilepsy who become pregnant are commonly considered to be at high risk for complications during pregnancy or delivery. The offspring are also considered to have increased risk of perinatal mortality, congenital malformations, and maturational delay. Because few of these studies are population based, potential bias exists because of selection.Methods: We performed a historical population-based cohort study in Iceland to determine the prevalence of epilepsy among pregnant women, to identify pregnancy and delivery complications in women with epilepsy, and to determine the outcome of their pregnancies as compared with that in the general population of Iceland. We identified all women with active epilepsy who gave birth during a 19-year period in Iceland.Results: In this population, 3.3 in 1,000 pregnancies involve mothers with active epilepsy. The frequency of adverse events (AE) during pregnancy in the women with epilepsy is similar to that observed among all live births in the population, but cesarean section was performed twice as frequently as in the general population. Perinatal mortality rate and mean birth weight are not significantly different in the offspring of women with epilepsy as compared with rest of the population. The risk of major congenital malformations (MGM) is increased 2.7-fold over that expected when a mother is treated with antiepileptic drugs (AEDs) during a pregnancy.Conclusions: Our study indicates that the rate of complications of pregnancy in mothers with active epilepsy is low and similar to that of the general population with epilepsy. Use of AEDs by the mother during pregnancy significantly increases the risk of MGM in the offspring. Key Words: Epidemiology-Epilepsy-Pregnancy-Congenital malformations-Iceland.Women with epilepsy who become pregnant are frequently considered to have a high risk of an adverse outcome (1,2). Numerous studies also indicate an increased risk of malformations (3,4) in offspring of mothers with epilepsy. Few population studies have determined the proportion of all pregnancies that occur in women with active epilepsy. We performed a population-based survey in Iceland to identify all women with epilepsy who gave birth during the 19-year period from 1972 through 1990. We wished to determine the proportion of pregnancies in women with active epilepsy among all pregnancies and to compare the proportion with complications of pregnancy, delivery, and outcome in those with and without epilepsy. PATIENTS AND METHODSIndex cases were all women with epilepsy treated with antiepileptic drugs (AEDs) during pregnancy or during a 5-year period preceding the pregnancy. All the women were residents of Iceland and gave birth in Iceland during the study period. Only live births, products of pregnancies progressing at least through week 28 of gestation were included. The study period was from January 1, 1972 to December 31, 1990.Index cases were identified from records of all the hospitals in the country where children are born. Supplemental inform...

A retrospective study was made to determine the incidence of pregnancy-induced hypertension (PIH, pre-eclampsia) in Iceland. One-fourth of all births in Iceland in 1985 were selected from the national birth registry files by random number allocation, a total of 904 women. Maternity records were found in 97.9% of the cases. The criteria used to define PIH were met in 17.4% of the women. There were 146 (16.5%) with mild PIH (blood pressure of greater than or equal to 140/90 mmHg with or without proteinuria after the 20th gestational week). Eight (0.9%) had severe PIH (blood pressure of greater than or equal to 160/110 mmHg with or without proteinuria after the 20th gestational week). Primigravid women formed one-third of the group and of these 20.9% had PIH compared with 15.4% of the parous women. The incidence in parous women was higher than usually reported.

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