Complications during pregnancy in women with epilepsy: population‐based cohort study

Borthen, Ingrid; Eide, MG; Veiby, Gyri; Daltveit, AK; Ne, Gilhus

doi:10.1111/j.1471-0528.2009.02354.x

Cited by 107 publications

(131 citation statements)

References 34 publications

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“…For example, women from low SES backgrounds and those who are unmarried (not living with a partner) appear to be more likely to experience maternal health conditions in pregnancy, which may contribute to their increased risk of delivering lower birth weight and/or lower gestational age infants. [54][55][56][57][58][59] The presence of significant effects here by both social disadvantage and health conditions in pregnancy reflect this dual layering of stress sources and the adverse implications for birth outcomes. As noted, cumulative stress models point to dysregulatory cascades across physiological systems, transferring effects of stress to birth outcomes.…”

Section: Discussionmentioning

confidence: 92%

“…52,53 Studies have also shown that pregnancy-related health conditions and maternal health conditions in pregnancy contribute to an increased risk of adverse birth outcomes. [54][55][56][57][58][59] Using data from a prospective cohort study, we examined the pathways linking maternal social disadvantage to birth outcomes. Weathering theory posits that social disadvantage influences health outcomes through physical embodiment mechanisms as well as psychosocial and health behavior pathways.…”

Section: Introductionmentioning

confidence: 99%

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Mediators of Adverse Birth Outcomes Among Socially Disadvantaged Women

Gavin

Nurius

Logan-Greene

2012

Journal of Women's Health

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Background: Numerous studies find that socially disadvantaged women are more likely than socially advantaged women to deliver infants that weigh less than normal and/or are born weeks prior to their due date. However, little is known about the pathways that link maternal social disadvantage to birth outcomes. Using data from a prospective cohort study, we examined whether antenatal psychosocial stress, substance use, and maternal health conditions in pregnancy mediated the pathway between maternal social disadvantage and birth outcomes. Methods: Analyses used structural equation modeling to examine data from a community clinic-based sample (n = 2168) of pregnant women who completed questionnaires assessing psychosocial functioning and health behaviors as well as sociodemographic characteristics, which were matched with subsequent birth outcome data. Results: Analyses revealed maternal social disadvantage predicted poorer birth outcomes through a mediated pathway including maternal health conditions in pregnancy.Conclusions: The findings demonstrate that maternal social disadvantage is associated with poor health status in pregnancy, which in turn adversely affects birth outcomes. Results argue for more systematic attention to the roles of social disadvantage, including life course perspectives that trace social disadvantage prior to and through pregnancy.

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Mediators of Adverse Birth Outcomes Among Socially Disadvantaged Women

Gavin

Nurius

Logan-Greene

2012

Journal of Women's Health

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“…Women with epilepsy have a low complication rate except of that related to AEDs exposure (Borthen et al, 2009). All of them in childbearing age should be informed about the rates of teratogenicity of AEDs, possibility of increased seizure frequency during pregnancy, and the risks of the pregnancy and labour.…”

Section: Discussionmentioning

confidence: 99%

Epilepsy and Anticonvulsant Therapy During Pregnancy

Maňáková¹,

Hubickova²

2011

Novel Treatment of Epilepsy

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“…Physicians providing care for pregnant women with epilepsy should be aware of a small but significant increase in the risk of complications during pregnancy, especially in women taking AEDs [4,5,21] [5]. No differences were found between the two groups in terms of perinatal death.…”

Section: Maternity Care During Pregnancymentioning

confidence: 99%

Managing epilepsy in women of childbearing age — Polish Society of Epileptology and Polish Gynecological Society Guidelines

Jędrzejczak¹,

Bomba‐Opoń²,

Jakiel³

et al. 2017

Ginekol Pol

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Epilepsy is the most common neurological disorder during pregnancy [1]. About one-third of women with epilepsy are of childbearing age. Statistically, between 0.3% and 0.5% of births occur in women with epilepsy [2]. Every year in Poland epilepsy poses a threat to the health of some 1800 pregnant women and their fetuses. According to British studies, the risk of death in pregnant women with epilepsy increases tenfold compared to pregnant women without epilepsy, mainly due to sudden unexpected death in epilepsy (SUDEP) [3]. Diagnostic and therapeutic advances in the field of epilepsy have contributed to better seizure control. As a result, more and more women with epilepsy become pregnant and more than 90% give birth to healthy children [4,5]. In order to avoid irregularities in the management of women suffering from epilepsy, it is very important to create standards for the management of women treated for epilepsy, both for those who are already pregnant and those who plan pregnancy. Thus the first edition of guidelines regarding management and care in women with epilepsy during preconception period and also during pregnancy, delivery, and postpartum were prepared by the experts of Polish Society of Epileptology and Polish Gynecological Society. The diagnosis, seizures classification and therapy of epilepsy were not included into the guidelines.The neurologists, gynecologists and family doctors should inform that the women with epilepsy could benefit from planning pregnancies to reduce the risk of fetal congenital malformations. Due to increased awareness and knowledge concerning epilepsy, the number of planned pregnancies is increasing, but 40% are still unplanned. The risk of major congenital malformations in the fetus increases in women with epilepsy taking antiepileptic drugs [6]. Fears of women with epilepsy in relation to the adverse effects of antiepileptic drugs on infants can lead to arbitrary withdrawal or dose reduction of antiepileptic drugs, and thus increase the risk of seizures and even SUDEP [4]. Therefore, women of reproductive age (15-44 years) treated for epilepsy should receive care from specialist epilepsy and gynecology clinics. DIAGNOSIS OF EPILEPSYEpilepsy is a heterogeneous group of diseases of the brain, the common symptoms of which are clinical seizures. After diagnosis of epilepsy, a neurologist determines the type of epileptic seizure and suggests appropriate treatment for epilepsy. Based on the course of the disease, neurologist can assess the degree of risk of neurological complications in pregnancy. Women who have not experienced seizures for at least 10 years (including five years without antiepileptic drugs) and those who were diagnosed with childhood epileptic syndrome, but have not experienced seizures in

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Complications during pregnancy in women with epilepsy: population‐based cohort study

Cited by 107 publications

References 34 publications

Mediators of Adverse Birth Outcomes Among Socially Disadvantaged Women

Mediators of Adverse Birth Outcomes Among Socially Disadvantaged Women

Epilepsy and Anticonvulsant Therapy During Pregnancy

Managing epilepsy in women of childbearing age — Polish Society of Epileptology and Polish Gynecological Society Guidelines

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