Pregnancy with epilepsy: obstetric and neonatal outcome of a controlled study.
Seizure
; 19(2): 112-9, 2010 Mar.
Article
en 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
Base de datos:
MEDLINE
Asunto principal:
Complicaciones del Embarazo
/
Epilepsia
/
Complicaciones del Trabajo de Parto
/
Anticonvulsivantes
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Idioma:
En
Revista:
Seizure
Asunto de la revista:
NEUROLOGIA
Año:
2010
Tipo del documento:
Article