Pregnancy with epilepsy: obstetric and neonatal outcome of a controlled study.
Seizure
; 19(2): 112-9, 2010 Mar.
Article
em En
| MEDLINE
| ID: mdl-20036166
ABSTRACT
PURPOSE:
To determine the influence of epilepsy and its treatment on pregnancy and its outcome.DESIGN:
Controlled, observational study.SETTING:
National Health Service maternity hospitals in Liverpool and Manchester regions. POPULATION 277 women with epilepsy (WWE) and 315 control women.METHODS:
WWE were recruited from antenatal clinics. Controls were matched for age and parity but not gestational age. Information was obtained by interview and from clinical records. MAIN OUTCOMEMEASURES:
Obstetric complications, mode of delivery, condition of newborn.RESULTS:
Distribution of epilepsy syndromes was similar to previous surveys. Most WWE (67%) received monotherapy with carbamazepine, sodium valproate or lamotrigine. Half WWE had no seizures during pregnancy but 34% had tonic clonic seizures. Seizure-related injuries were infrequent. Pregnancies with obstetric complications were increased in women with treated epilepsy (WWTE 45%, controls 33%; p=0.01). Most had normal vaginal delivery (WWTE 63%, controls 61%; p=0.65). Low birth weight was not increased (WWTE 6.2%, controls 5.2%; p=0.69). There were more major congenital malformations (MCM) (WWTE 6.6%, controls 2.1%; p=0.02) and fetal/infant deaths (WWTE 2.2%, controls 0.3%; p=0.09). Amongst monotherapies MCM prevalence was highest with valproate (11.3%; p=0.005). Lamotrigine (5.4%; p=0.23) and carbamazepine (3.0%; p=0.65) were closer to controls (2.1%). There was no association between MCM and dose of folic acid pre-conception.CONCLUSION:
MCM were more prevalent in the babies of WWTE particularly amongst those receiving sodium valproate.
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
/
2_ODS3
/
6_ODS3_enfermedades_notrasmisibles
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7_ODS3_muertes_prevenibles_nacidos_ninos
Base de dados:
MEDLINE
Assunto principal:
Complicações na Gravidez
/
Epilepsia
/
Complicações do Trabalho de Parto
/
Anticonvulsivantes
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Newborn
/
Pregnancy
Idioma:
En
Revista:
Seizure
Ano de publicação:
2010
Tipo de documento:
Article