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Published on: June 11, 2020
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Maternal morbidity and mortality associated with epilepsy.
Cynthia Gyamfi-Bannerman1, Yongmei Huang1, Brian T Bateman2,3
1Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Columbia University Irving Medical Center, New York, NY, USA.
Summary
Women with epilepsy on antiepileptic drugs showed no increased risk of maternal death. However, they experienced a modest increase in risks for severe maternal morbidity and other adverse outcomes during delivery hospitalizations.
Area of Science:
- Obstetrics and Gynecology
- Neurology
- Public Health
Background:
- Previous studies indicated a significantly elevated risk of maternal mortality for women with epilepsy.
- Understanding the specific risks associated with delivery hospitalizations for women with epilepsy is crucial for improving maternal care.
Purpose of the Study:
- To assess the risk of adverse maternal outcomes during delivery hospitalizations among women diagnosed with epilepsy.
- To compare outcomes between women with epilepsy receiving antiepileptic drugs and those without epilepsy.
Main Methods:
- Utilized Truven Health MarketScan databases for a comparative analysis.
- Included outcomes such as maternal death, severe maternal morbidity, cesarean delivery, postpartum hemorrhage, placental abruption, preeclampsia, preterm delivery, premature rupture of membranes, and stillbirth.
- Employed adjusted models with risk ratios (aRR) and 95% confidence intervals (CIs), controlling for hospital and demographic factors.
Main Results:
- Women with epilepsy receiving antiepileptic drugs (n=6019) did not have an increased risk of mortality (p=0.27).
- This group showed a doubled risk for severe maternal morbidity (aRR 2.16, 95% CI 1.86-2.51).
- Slightly increased risks were observed for placental abruption (aRR 1.29), cesarean delivery (aRR 1.14), and preterm delivery (aRR 1.25) compared to women without epilepsy.
Conclusions:
- Epilepsy in pregnant women on antiepileptic drugs was not associated with a significant difference in mortality risk.
- The study found a modest increase in the risk of other adverse maternal outcomes for women with epilepsy on antiepileptic medications.
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