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Obstetric outcome in women with epilepsy: a hospital-based, retrospective study

  1. I Borthen1,2,
  2. MG Eide2,
  3. AK Daltveit3,4,
  4. NE Gilhus1,5

Article first published online: 11 MAY 2011

DOI: 10.1111/j.1471-0528.2011.03004.x

Issue

BJOG: An International Journal of Obstetrics & Gynaecology

BJOG: An International Journal of Obstetrics & Gynaecology

Volume 118, Issue 8, pages 956–965, July 2011

Additional Information

How to Cite

Borthen, I., Eide, M., Daltveit, A. and Gilhus, N. (2011), Obstetric outcome in women with epilepsy: a hospital-based, retrospective study. BJOG: An International Journal of Obstetrics & Gynaecology, 118: 956–965. doi: 10.1111/j.1471-0528.2011.03004.x

Author Information

  1. 1

    Department of Clinical Medicine, University of Bergen

  2. 2

    Department of Obstetrics and Gynaecology, Haukeland University Hospital, Bergen

  3. 3

    Department of Public Health and Primary Health Care, University of Bergen

  4. 4

    Medical Birth Registry of Norway, Norwegian Institute of Public Health, Bergen

  5. 5

    Department of Neurology, Haukeland University Hospital, Bergen, Norway

*Dr I Borthen, Department of Gynaecology and Obstetrics, Haukeland University Hospital, 5021 Bergen, Norway. Email ingrid.borthen@med.uib.no

Publication History

  1. Issue published online: 10 JUN 2011
  2. Article first published online: 11 MAY 2011
  3. Accepted 16 March 2011. Published Online 11 May 2011.

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Keywords:

  • Antiepileptic drugs;
  • delivery;
  • epilepsy;
  • pregnancy

Please cite this paper as: Borthen I, Eide M, Daltveit A, Gilhus N. Obstetric outcome in women with epilepsy: a hospital-based, retrospective study. BJOG 2011;118:956–965.

Objective  To report the complications during pregnancy and delivery in women with epilepsy, compared with a control group without epilepsy, with special focus on potential risk factors, such as epilepsy severity and dosage of antiepileptic drugs.

Design  Hospital-based retrospective study.

Setting  Data from pregnancy notification forms and hospital case records.

Population  Women with a past or present history of epilepsy (n = 205) delivered in Bergen, Norway, in the period 1999–2006, and a matched control group of women (n = 205) without epilepsy.

Methods  Data were compared and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated by multiple logistic regression models.

Main outcome measures  Pre-eclampsia (mild and severe), gestational hypertension, vaginal bleeding (early and late), caesarean section, vaginal operative delivery, postpartum haemorrhage and major malformations.

Results  Women with epilepsy using antiepileptic drugs had an increased risk of severe pre-eclampsia (OR, 5.0; 95% CI, 1.3–19.9), bleeding in early pregnancy (OR, 6.4; 95% CI, 2.7–15.2), induction (OR, 2.3; 95% CI, 1.2–4.3) and caesarean section (OR, 2.5; 95% CI, 1.4–4.7) adjusted for maternal age, parity, education, smoking, medical conditions and body mass index ≥30 kg/m2. There was also an increased risk of malformations in the offspring (OR, 7.1; 95% CI, 1.4–36.6). Women without antiepileptic drug use had increased risks of forceps delivery and preterm birth. Active epilepsy (seizures during the last 5 years) versus nonactive epilepsy did not discriminate for any of these complications; 84.5% of women with epilepsy and antiepileptic drug use were using folate.

Conclusion  Women with epilepsy using antiepileptic drugs had an increased risk of pregnancy and delivery complications, whereas women not using antiepileptic drugs had few complications. Seizures, high doses of antiepileptic drugs, obesity and lack of folate could not explain these increased risks.

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