Maternal and obstetric outcome of women with epilepsy

Medical professionals and public are concerned about the complications of pregnancy and delivery in women with epilepsy (WWE).

Our aim was to prospectively ascertain occurrence of these complications in a cohort of WWE enrolled in a pregnancy registry.

All complications during pregnancy, delivery and first 48 h of postpartum period were recorded according to the registry protocol. This data were compared with similar statistics (for women without epilepsy) from a large teaching hospital.

Between April 1998 and March 2005, there were 643 completed pregnancies in this registry. (Mean age 25.7+/-4.43 years; generalized epilepsy 46%; localization related epilepsy 54%; primigravida 53%.) Their complications are compared with those of 18,272 pregnancies managed in the teaching hospital (in parentheses). Spontaneous abortions 4.2% (2.38%); medical termination of pregnancies 2.64% (7.71%); anemia 0.62% (0.22%); gestational diabetes 1.56% (3.09%); pregnancy induced hypertension 3.89% (6.45%); antepartum hemorrhage 0.93% (1.64%); preterm labor 1.87% (6.12%); obstructed labor 0.62% (3%); cesarean section 33.4% (29.5%); assisted delivery 2.8% (2.68%); postpartum hemorrhage 0.31% (0.64%); peripartum seizures 1.4% (0.04%); intrauterine death 1.56% (2.2%); fibroid uterus or ovarian cyst 2.33% (0.53%); other medical illness 2.5% (2.15%); TORCH infection 0.31% (0.01%); birth weight <2.0 kg 4.19% (7.66%).

There was no significant increase in the risk of complications of pregnancy or delivery except for spontaneous abortions, anemia, ovarian cyst, fibroid uterus, and seizures in the peripartum period which were more frequent in WWE. Frequency of cesarean section is not increased in WWE. There is no undue risk to pregnancy and childbirth in most WWE.