New-onset epilepsy in pregnant women: clinical features and delivery outcomes

Most seizures during pregnancy occur in women who already have epilepsy. Rarely, some women may have their first seizure during pregnancy. The purpose of this study was to investigate the clinical features and pregnancy outcomes in women with new-onset epilepsy during pregnancy.

112 pregnant women with epilepsy were prospectively evaluated at the Education - Therapeutic Clinic of the Azerbaijan Medical University, in the neurological and maternity departments of the Clinical Medical Center in Baku over a six-year period. Women were regularly followed by a neurologist and obstetrician till the end of pregnancy. To determine the recurrence of seizures during the pregnancy and after delivery, the women were followed up at least once per three months for a one year period after delivery. Delivery and perinatal outcomes were compared with those of 277 healthy women in the control group (without epilepsy and without registering chronic diseases).

Of the 112 pregnant women with epilepsy, 12 (10.7%) had their first seizures during the pregnancy: 6 in the 1^st, 4 in the 2^nd, 2 in the 3^rd trimester. Women with new-onset epilepsy had increased risk of cesarean section and perinatal hypoxia in offspring, compared with controls (Odds ratio [OR]: 13.57; 95% confidence interval (CI):2.86-64.31 and OR: 3.61; 95 % CI: 1.06-12.27, respectively). The risks of cesarean section and perinatal hypoxia were not increased in women with new-onset epilepsy compared to women with epilepsy before pregnancy (OR 2.64; 95 % CI 0.54-12.93 and OR 2.18, 95% CI 0.61-7.76, respectively).

In our cohort, women with new-onset epilepsy may have an increased risk of delivery by cesarean section and perinatal hypoxia compared to pregnant controls. The risks were not increased compared to women with epilepsy before pregnancy. Neonatal hypoxia was associated with delivery by cesarean section.