The course and outcome of pregnancy and neonatal situation in epileptic women

Najafi, Mohammad Reza; Sonbolestan, Farnoosh; Sonbolestan, Seyed Ali; Zare, Mohammad; Mehvari, Jafar; Meshkati, Shahrokh Noori

doi:10.4103/2277-9175.94426

Cited by 9 publications

(4 citation statements)

References 21 publications

(26 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There were 45 retrospective and 21 prospective cohort studies, 9 case-control studies, and 1 cross-sectional study . Sixty-two articles had a low risk of bias and 14 a high risk of bias (eTable 2 in Supplement 1).…”

Section: Resultsmentioning

confidence: 99%

Comparison of Perinatal Outcomes for Women With and Without Epilepsy

et al. 2023

View full text Add to dashboard Cite

ImportancePregnant women who have epilepsy need adequate engagement, information, and pregnancy planning and management to improve pregnancy outcomes.ObjectiveTo investigate perinatal outcomes in women with epilepsy compared with women without epilepsy.Data SourcesOvid MEDLINE, Embase, CINAHL, and PsycINFO were searched with no language or date restrictions (database inception through December 6, 2022). Searches also included OpenGrey and Google Scholar and manual searching in journals and reference lists of included studies.Study SelectionAll observational studies comparing women with and without epilepsy were included.Data Extraction and SynthesisThe PRISMA checklist was used for abstracting data and the Newcastle-Ottawa Scale for risk-of-bias assessment. Data extraction and risk-of-bias assessment were done independently by 2 authors with mediation conducted independently by a third author. Pooled unadjusted odds ratios (OR) or mean differences were reported with 95% CI from random-effects (I2 heterogeneity statistic &gt;50%) or fixed-effects (I2 &lt; 50%) meta-analyses.Main Outcomes and MeasuresMaternal, fetal, and neonatal complications.ResultsOf 8313 articles identified, 76 were included in the meta-analyses. Women with epilepsy had increased odds of miscarriage (12 articles, 25 478 pregnancies; OR, 1.62; 95% CI, 1.15-2.29), stillbirth (20 articles, 28 134 229 pregnancies; OR, 1.37; 95% CI, 1.29-1.47), preterm birth (37 articles, 29 268 866 pregnancies; OR, 1.41; 95% CI, 1.32-1.51) and maternal death (4 articles, 23 288 083 pregnancies; OR, 5.00; 95% CI, 1.38-18.04). Neonates born to women with epilepsy had increased odds of congenital conditions (29 articles, 24 238 334 pregnancies; OR, 1.88; 95% CI, 1.66-2.12), neonatal intensive care unit admission (8 articles, 1 204 428 pregnancies; OR, 1.99; 95% CI, 1.58-2.51), and neonatal or infant death (13 articles, 1 426 692 pregnancies; OR, 1.87; 95% CI, 1.56-2.24). The increased odds of poor outcomes was increased with greater use of antiseizure medication.Conclusions and RelevanceThis systematic review and meta-analysis found that women with epilepsy have worse perinatal outcomes compared with women without epilepsy. Women with epilepsy should receive pregnancy counseling from an epilepsy specialist who can also optimize their antiseizure medication regimen before and during pregnancy.

show abstract

Section: Resultsmentioning

confidence: 99%

Comparison of Perinatal Outcomes for Women With and Without Epilepsy

et al. 2023

View full text Add to dashboard Cite

show abstract

“…Due to this clue, something new might come to our mind that why these epileptic patients have even less BMI than the studied population? To find the answer, we must consider lots of factors, for example, neuropsychiatric, socioeconomic, genetic risks, and pregnancy,[ 53 54 55 56 57 ] which may interfere with our results. In addition, simultaneous study of other factors, for example, depression, nutrition in epileptic patients could help to find a true prevalence of this side effect.…”

Section: Discussionmentioning

confidence: 99%

The Investigation of Insulin Resistance in Two Groups of Epileptic Patients Treated with Sodium Valproate and Carbamazepine

et al. 2017

Self Cite

View full text Add to dashboard Cite

Background:Valproic acid (VPA) is a widely used broad-spectrum antiepileptic drug for therapy of generalized and focal epilepsies. Cross-sectional studies have suggested that valproate treatment may be associated with hyperinsulinemia. We decided to investigate hyperinsulinemia as a health-threatening side effect of VPA in Iranian epileptic patients.Materials and Methods:Body mass index (BMI), lipid profile, fasting serum insulin, fasting blood glucose (FBS), and homeostatic model assessment-insulin resistance (HOMA-IR) were measured in 30 VPA-treated epileptic patients and 30 controls (CBZ-treated). The Chi-square test, t-test, and Pearson correlation test were used.Results:BMI was higher in VPA group than in control group (25.7 ± 3.5 > 21.7 ± 4.1) (0.000 < 0.05). Prevalence of obesity was 16.6% in VPA group that was almost the same and even lower than general Iranian population. Serum triglyceride (TG) (150 ± 77.2) was higher than CBZ group (114 ± 35.2) (P = 0.023 < 0.05). However, serum high-density lipoprotein level was lower in VPA group than controls (45.2 ± 11.7 < 54.4 ± 13.9) (P = 0.008 < 0.05). Serum insulin, FBS, HOMA-IR, cholesterol, and low-density lipoprotein did not demonstrate statistically significant differences between the two groups (P > 0.05).Conclusion:Despite the majority of previous studies that are against VPA and according to our study, VPA could be prescribed safely and it may not cause IR and its complications.

show abstract

“…It could probably mention the effect of sexual hormones (progesterone) on epilepsy especially high concentrations of them during pregnancy. [26] Acetate progesterone plays a vital role in catamenial epilepsy, anti-epileptic and anti-seizure properties of which are well-known in human beings and animals. [24] It is showed that catamenial seizure is in a direct association with the progesterone level.…”

Section: Discussionmentioning

confidence: 99%

Progesterone therapy in women with intractable catamenial epilepsy

Najafi¹,

Sadeghi²,

Mehvari³

et al. 2013

Adv Biomed Res

Self Cite

View full text Add to dashboard Cite

Background:Catamenial epilepsy is a kind of epilepsy, known in this name, when the periodicity of the exacerbation of the seizure is in association with menstural cycle. The present study examined the progesterone effectiveness as a complementary treatment in women with intractable catamenial epilepsy.Materials and Methods:The present study was conducted as a double-blind randomized controlled trial on 38 women with intractable catamenial epilepsy. Patients were assessed in two groups: The case group received in addition to AEDs, two (Mejestrol) 40 mg progesterone tablets in the second half of the cycle from 15th to 25th day. And the control group received in addition to AEDs, two placebo tablets daily. Age, BMI, epilepsy duration, types of the drugs used, progesterone level, and the number of the seizures in 3 months before and after the study were compared.Results:Based on the results of which there was no statistically significant difference in regard to age, BMI, epilepsy duration, types of the drugs used, progesterone level between the case and the control groups (P-value > 0.05). The number of the seizures after treatment has significantly decreased compared to before-treatment state. The degree of decreasing in the case group receiving the progesterone was higher than in the control group receiving the placebo. The difference, thus, is significant, based on statistical tests (P-value = 0.024).Conclusion:Based on the findings of this study using progesterone in women with intractable catamenial epilepsy has a significant effect on the degree of decreasing in the number of the seizures.

show abstract

The course and outcome of pregnancy and neonatal situation in epileptic women

Cited by 9 publications

References 21 publications

Comparison of Perinatal Outcomes for Women With and Without Epilepsy

Comparison of Perinatal Outcomes for Women With and Without Epilepsy

The Investigation of Insulin Resistance in Two Groups of Epileptic Patients Treated with Sodium Valproate and Carbamazepine

Progesterone therapy in women with intractable catamenial epilepsy

Contact Info

Product

Resources

About