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Farmen, A. H.; Grundt, J. H.; Nakling, J. O.; Mowinckel, P.; Nakken, K. O.; Lossius, M. I.

Increased rate of acute caesarean sections in women with epilepsy: results from the Oppland Perinatal Database in Norway

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  • Media type: E-Article
  • Title: Increased rate of acute caesarean sections in women with epilepsy: results from the Oppland Perinatal Database in Norway
  • Contributor: Farmen, A. H.; Grundt, J. H.; Nakling, J. O.; Mowinckel, P.; Nakken, K. O.; Lossius, M. I.
  • imprint: Wiley, 2019
  • Published in: European Journal of Neurology
  • Language: English
  • DOI: 10.1111/ene.13865
  • ISSN: 1351-5101; 1468-1331
  • Origination:
  • Footnote:
  • Description: <jats:sec><jats:title>Background and purpose</jats:title><jats:p>Studies in women with epilepsy (<jats:styled-content style="fixed-case">WWE</jats:styled-content>) regarding pregnancy and labour complications have disclosed contradictory results. Our purpose was to investigate whether <jats:styled-content style="fixed-case">WWE</jats:styled-content> have a higher risk of acute caesarean section (<jats:styled-content style="fixed-case">CS</jats:styled-content>) or pregnancy complications than women without epilepsy or women with other chronic diseases and, if we found a higher risk, to explore potential explanations.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>The study used prospectively registered obstetric data from the Oppland Perinatal Database in the period 2001–2011, containing information on 18 244 births, including 110 singleton pregnancies in mothers with validated epilepsy. Data regarding epilepsy were collected retrospectively from medical records.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Epilepsy was a significant risk factor for acute <jats:styled-content style="fixed-case">CS</jats:styled-content>, breech presentation and low birth weight in offspring [odds ratio (<jats:styled-content style="fixed-case">OR),</jats:styled-content> 1.93, 95% confidence interval (CI), 1.2–3.1; <jats:styled-content style="fixed-case">OR,</jats:styled-content> 2.29, 95% <jats:styled-content style="fixed-case">CI,</jats:styled-content> 1.2–4.6 and <jats:styled-content style="fixed-case">OR,</jats:styled-content> 2.10, 95% <jats:styled-content style="fixed-case">CI,</jats:styled-content> 1.0–4.2, respectively]. In multivariate logistic regression analysis, antiepileptic drug exposure was an independent risk factor for acute <jats:styled-content style="fixed-case">CS</jats:styled-content> (<jats:styled-content style="fixed-case">OR,</jats:styled-content> 2.00; 95% <jats:styled-content style="fixed-case">CI,</jats:styled-content> 1.06–3.77) and polytherapy was a significant risk factor for breech presentation (<jats:styled-content style="fixed-case">OR,</jats:styled-content> 5.37; 95% <jats:styled-content style="fixed-case">CI,</jats:styled-content> 1.13–25.57). Seizure frequency during pregnancy had no influence on the complication rate.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>We found that WWE using antiepileptic drugs during pregnancy had increased rates of acute <jats:styled-content style="fixed-case">CS</jats:styled-content>, breech presentation and low birth weight, and that seizure frequency during pregnancy did not influence the complication rate.</jats:p></jats:sec>