open access

Vol 54, No 1 (2020)
Research Paper
Submitted: 2019-08-05
Accepted: 2019-11-16
Published online: 2020-01-17
Get Citation

Obstetric and neonatal outcomes in women with epilepsy in Poland — a two-centre study

Magdalena Bosak1, Bryan H. Song1, Milena Dewerenda-Sikora2, Agnieszka Słowik1, Anetta Lasek-Bal2
·
Pubmed: 31956972
·
Neurol Neurochir Pol 2020;54(1):62-65.
Affiliations
  1. Collegium Medicum, Jagiellonian University of Krakow, Poland
  2. School of Health Sciences, Medical University of Silesia, Ziołowa 45/47, 40-635 Katowice, Poland

open access

Vol 54, No 1 (2020)
Research papers
Submitted: 2019-08-05
Accepted: 2019-11-16
Published online: 2020-01-17

Abstract

Aim of the study. To report pregnancy, delivery and perinatal outcomes in women with epilepsy seen in university clinics in Poland. Clinical rationale for the study. Women with epilepsy are reported to be at increased risk of adverse pregnancy and foetal outcomes.

Materials and methods. The following data was collected in 171 pregnant women seen in two university epilepsy clinics: epilepsy characteristics and treatment, seizure frequency, pregnancy outcomes, perinatal outcomes, and feeding method.

Results.
The mean age of patients at the time of delivery was 28.8 years, and most women were nulliparous. Almost 80% of patients were on monotherapy and the majority were prescribed antiepileptic drugs with low teratogenic potential. 53.8% of patients were seizure-free during pregnancy. Half of the cohort delivered by caesarean section and the majority delivered in term. Nearly all newborns scored > 7 Apgar points. Major congenital malformation was diagnosed in only one foetus. Any adverse pregnancy/neonatal outcome was found in 13% of patients. Two thirds of women reported breastfeeding at any time.

Conclusions and clinical implications. Almost 90% of women continued antiepileptic therapy during pregnancy. 46% of patients had epileptic seizures during pregnancy. Any adverse pregnancy/neonatal outcome was found in 13% of women with epilepsy. The majority of patients delivered healthy babies. Further studies are needed to find risk factors for adverse pregnancy/neonatal outcomes in women with epilepsy in Poland.

Abstract

Aim of the study. To report pregnancy, delivery and perinatal outcomes in women with epilepsy seen in university clinics in Poland. Clinical rationale for the study. Women with epilepsy are reported to be at increased risk of adverse pregnancy and foetal outcomes.

Materials and methods. The following data was collected in 171 pregnant women seen in two university epilepsy clinics: epilepsy characteristics and treatment, seizure frequency, pregnancy outcomes, perinatal outcomes, and feeding method.

Results.
The mean age of patients at the time of delivery was 28.8 years, and most women were nulliparous. Almost 80% of patients were on monotherapy and the majority were prescribed antiepileptic drugs with low teratogenic potential. 53.8% of patients were seizure-free during pregnancy. Half of the cohort delivered by caesarean section and the majority delivered in term. Nearly all newborns scored > 7 Apgar points. Major congenital malformation was diagnosed in only one foetus. Any adverse pregnancy/neonatal outcome was found in 13% of patients. Two thirds of women reported breastfeeding at any time.

Conclusions and clinical implications. Almost 90% of women continued antiepileptic therapy during pregnancy. 46% of patients had epileptic seizures during pregnancy. Any adverse pregnancy/neonatal outcome was found in 13% of women with epilepsy. The majority of patients delivered healthy babies. Further studies are needed to find risk factors for adverse pregnancy/neonatal outcomes in women with epilepsy in Poland.

Get Citation

Keywords

epilepsy, women, pregnancy, delivery, perinatal outcomes

About this article
Title

Obstetric and neonatal outcomes in women with epilepsy in Poland — a two-centre study

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 54, No 1 (2020)

Article type

Research Paper

Pages

62-65

Published online

2020-01-17

Page views

1372

Article views/downloads

396

DOI

10.5603/PJNNS.a2020.0003

Pubmed

31956972

Bibliographic record

Neurol Neurochir Pol 2020;54(1):62-65.

Keywords

epilepsy
women
pregnancy
delivery
perinatal outcomes

Authors

Magdalena Bosak
Bryan H. Song
Milena Dewerenda-Sikora
Agnieszka Słowik
Anetta Lasek-Bal

References (17)
  1. Jette N, Fiest KM, Sauro KM, et al. Prevalence and incidence of epilepsy: A systematic review and meta-analysis of international studies. Neurology. 2017; 88(3): 296–303.
  2. Wallace H, Shorvon S, Tallis R. Age-specific incidence and prevalence rates of treated epilepsy in an unselected population of 2,052,922 and age-specific fertility rates of women with epilepsy. Lancet. 1998; 352(9145): 1970–1973.
  3. Razaz N, Tomson T, Wikström AK, et al. Association Between Pregnancy and Perinatal Outcomes Among Women With Epilepsy. JAMA Neurol. 2017; 74(8): 983–991.
  4. Tomson T, Battino D, Bonizzoni E, et al. EURAP Study Group. Comparative risk of major congenital malformations with eight different antiepileptic drugs: a prospective cohort study of the EURAP registry. Lancet Neurol. 2018; 17(6): 530–538.
  5. Viale L, Allotey J, Cheong-See F, et al. EBM CONNECT Collaboration. Epilepsy in pregnancy and reproductive outcomes: a systematic review and meta-analysis. Lancet. 2015; 386(10006): 1845–1852.
  6. Meador KJ, Baker GA, Browning N, et al. NEAD Study Group. Fetal antiepileptic drug exposure and cognitive outcomes at age 6 years (NEAD study): a prospective observational study. Lancet Neurol. 2013; 12(3): 244–252.
  7. Harden CL, Meador KJ, Pennell PB, et al. American Academy of Neurology, American Epilepsy Society. Management issues for women with epilepsy-Focus on pregnancy (an evidence-based review): II. Teratogenesis and perinatal outcomes: Report of the Quality Standards Subcommittee and Therapeutics and Technology Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Epilepsia. 2009; 50(5): 1237–1246.
  8. Patel SI, Pennell PB. Management of epilepsy during pregnancy: an update. Ther Adv Neurol Disord. 2016; 9(2): 118–129.
  9. Battino D, Tomson T, Bonizzoni E, et al. EURAP Study Group. Seizure control and treatment changes in pregnancy: observations from the EURAP epilepsy pregnancy registry. Epilepsia. 2013; 54(9): 1621–1627.
  10. Pennell PB, Peng L, Newport DJ, et al. Lamotrigine in pregnancy: clearance, therapeutic drug monitoring, and seizure frequency. Neurology. 2008; 70(22 Pt 2): 2130–2136.
  11. Vajda FJE, O'Brien T, Lander C, et al. The efficacy of the newer antiepileptic drugs in controlling seizures in pregnancy. Epilepsia. 2014; 55(8): 1229–1234.
  12. http://www.imid.med.pl/files/imid/Aktualnosci/Aktualnosci/Dane%20statystyczne%20EURO-PERISTAT%20+%20IMiD%20+%20GUS.pdf (01 March 2019).
  13. Jędrzejczak J, Bomba-Opoń D, Jakiel G, et al. Managing epilepsy in women of childbearing age - Polish Society of Epileptology and Polish Gynecological Society Guidelines. Ginekol Pol. 2017; 88(5): 278–284.
  14. Danielsson KC, Borthen I, Morken NH, et al. Hypertensive pregnancy complications in women with epilepsy and antiepileptic drugs: a population-based cohort study of first pregnancies in Norway. BMJ Open. 2018; 8(4): e020998.
  15. Meador KJ, Baker GA, Browning N, et al. Neurodevelopmental Effects of Antiepileptic Drugs (NEAD) Study Group, NEAD Study Group. Effects of breastfeeding in children of women taking antiepileptic drugs. Neurology. 2010; 75(22): 1954–1960.
  16. Meador KJ, Baker GA, Browning N, et al. Neurodevelopmental Effects of Antiepileptic Drugs (NEAD) Study Group. Breastfeeding in children of women taking antiepileptic drugs: cognitive outcomes at age 6 years. JAMA Pediatr. 2014; 168(8): 729–736.
  17. Johnson EL, Burke AE, Wang A, et al. Unintended pregnancy, prenatal care, newborn outcomes, and breastfeeding in women with epilepsy. Neurology. 2018; 91(11): e1031–e1039.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., ul. Świętokrzyska 73, 80–180 Gdańsk, Poland
tel.:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: viamedica@viamedica.pl