Women with epilepsy are more likely to experience maternal and fetal complications during pregnancy. This is the main conclusion of a study published earlier this year in JAMA Neurology (2023; online March 13).
The combination of epilepsy and pregnancy creates additional risks. This is due to a possible increase in the frequency of seizures, the use of anti-epileptic drugs and the increased occurrence of congenital abnormalities in the child. In order to develop adequate guidelines for pregnant women with epilepsy, it is important to know the exact risks of epilepsy during pregnancy. Therefore, British researchers conducted a systematic review and meta-analysis of studies comparing perinatal outcomes from the beginning of pregnancy to one year after delivery in women with and without epilepsy. The influence of antiepileptic drugs was also examined by comparing the outcomes of pregnant women with epilepsy who did and did not use antiepileptic drugs.
The review yielded 8313 articles of which 76 could be included. The results show that women with epilepsy had an increased risk of miscarriage (odds ratio (OR): 1.62; 95% CI: 1.15-2.29), stillbirth (OR: 1.37; 95% CI: 1.29-1.47), preterm birth (OR: 1.41; 95% CI: 1.32-1.51) and maternal mortality (OR: 5.00; 95% CI: 1.38 -18.04). Neonates of women with epilepsy also had an increased risk of congenital disorders (OR: 1.88; 95% CI: 1.66-2.12), admission to a neonatal intensive care unit (OR: 1.99, 95 % CI: 1.58-2.51) and mortality in the first year of life (OR: 1.87; 95% CI: 1.56-2.24). Women taking multiple antiepileptic drugs were found to have the highest risk of poor perinatal outcome.
The results of the meta-analysis underline the importance of comprehensive preconception counseling, pregnancy planning and guidance of pregnant women with epilepsy to ensure an optimal outcome for mother and child. In addition, doctors and women with epilepsy should take into account an increased risk of an unfavorable pregnancy outcome. In addition, the researchers say it is important that women with epilepsy receive advice from a specialized neurologist about the use of anti-epileptic drugs during pregnancy.
2023-12-13 05:00:00
#Worse #perinatal #outcomes #epilepsy
