Association Between Pregnancy and Perinatal Outcomes Among Women With Epilepsy

Abstract

IMPORTANCE To date, few attempts have been made to examine associations between exposure to maternal epilepsy with or without antiepileptic drug (AED) therapy and pregnancy and perinatal outcomes.OBJECTIVES To investigate associations between epilepsy in pregnancy and risks of pregnancy and perinatal outcomes as well as whether use of AEDs influenced risks. DESIGN, SETTING, AND PARTICIPANTSA population-based cohort study was conducted on all singleton births at 22 or more completed gestational weeks in Sweden from 1997 through 2011; of these, 1 424 279 were included in the sample. Information on AED exposure was

In utero exposure to antiepileptic drugs is associated with learning disabilities among offspring

“…Women on antiepileptic drugs during pregnancy are able to have a normal and favourable outcome 3. Some studies suggest increased risks of both congenital malformations and impaired neurodevelopment across cognitive, motor and behavioural domains among offspring exposed to antiepileptic drugs in utero 4–8.…”

Study suggests that pre-existing maternal epilepsy increases the risk of adverse perinatal outcomes

“…In this study, Razaz et al demonstrate through linked data analysis that AEDs did not increase the risk of complications in live births >22 weeks gestation, including congenital malformations 3. Artama et al used data from the Finnish National Health Register (1996–2008) to examine the outcomes of 4867 live and still births of women with epilepsy and exposed to AEDs (3067, 63%) and found that AED treatment (n=1800) only slightly increased the risk of admission into a neonatal care unit 4.…”

“…Razaz et al 3 used linked administrative data to determine perinatal outcomes for women diagnosed with epilepsy from hospital inpatient and outpatient records in Sweden between 1997 and 2011. A subset of women who were treated with AEDs 30 days before the estimated date of conception to birth between 2005 and 2011 were also identified from the Prescribed Drug Registry and their outcomes were assessed with propensity scoring to optimise adjustment for covariates such as maternal habitus and physical and psychiatric comorbidities.…”

The role of ethnicity on pregnancy outcomes in women with epilepsy: The need for specific research

“…The risk of preterm delivery has been reported to be almost increased 2‐fold in WWE, but this was not reported in all studies . Prematurity is obviously increased in AED‐exposed infants, especially in those with polytherapy treatment …”