Epilepsy and Pregnancy

Svigos, John

doi:10.1111/j.1479-828x.1984.tb01485.x

Cited by 24 publications

(14 citation statements)

References 14 publications

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“…There have been conflicting results in previous studies regarding epilepsy and preterm delivery. Some studies have reported an increased risk 9,10 and others have not 11–14 . Most studies of epilepsy and pregnancy outcome have failed to report on duration of gestation, and methods of estimating gestational age have been described in few studies.…”

Section: Discussionmentioning

confidence: 99%

Epilepsy and pregnancy: effect of antiepileptic drugs and lifestyle on birthweight

Hvas

Henriksen

Østergaard

et al. 2000

BJOG

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Objective To investigate the impact of epilepsy and antiepileptic drugs on length of gestation and Design Cohort study based on questionnaires mailed to all pregnant women who attended for prenatal Setting Department of Obstetrics and Gynaecology at Aarhus University Hospital, Denmark.Participants One hundred and ninety-three singleton pregnancies in women with epilepsy were compared with 24,094 singleton pregnancies in women without epilepsy.Main outcome measures Preterm delivery, small for gestational age, mean gestational age, gestational age-adjusted birthweight, head circumference, and body length.Results Children of women with epilepsy who smoked had lower gestational age and were at increased risk of preterm delivery (OR 3.4; 95% CI 1-8-6-5), compared with children born by nonepileptic women who smoked. Birthweight adjusted for gestational age was reduced by 102 g (95% CI 40-164) in women with epilepsy, and the risk of delivering a child who was small for gestational age was increased (adjusted OR 1.9,95% CI 1-3-2.7). compared with women without epilepsy. Newborn babies of women with epilepsy treated by drugs had a reduced adjusted birthweight (208 g, 95% CI 116-300), head circumference (0.4 cm, 95% CI 0 -0 4 7 ) , and body length (0.5 cm, 95% CI 0-1-1.0), compared with the newborn infants of women without epilepsy.Women with epilepsy who smoked were at increased risk of preterm delivery compared with healthy smokers. Children of women with drug treated epilepsy had lower birthweight, length, and head circumference than children of women without epilepsy.

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Section: Discussionmentioning

confidence: 99%

Epilepsy and pregnancy: effect of antiepileptic drugs and lifestyle on birthweight

Hvas

Henriksen

Østergaard

et al. 2000

BJOG

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“…Nelson and Ellenberg f 1982) found epileptic women to be just as likely to have increased vaginal bleeding during the first as in the third trimester. Not surprisingly, anemia has been described twice as often in women with epilepsy (Svigos, 1984). Hyperemesis gravidarum occurs more frequently in these patients (Bjerkdal and Bahna, 1973;Nelson and Ellenberg, 1982), which may complicate compliance with oral medication.…”

Section: Complications Of Pregnancymentioning

confidence: 99%

“…It differs from other hemorrhagic disorders in infancy in that the bleeding tends to occur internally during the first 24 h of life. First described by van Creveld (1957) and delineated as a syndrome by Mountain et al (1970), it was initially thought to be associated with exposure to phenobarbital or primidone, but has subsequently been described in children exposed to phenytoin, carbamazepine, diaze- Janz, 1964Speidel and Meadow, 1972Bjerkdal and Bahna, 1973Fedrick, 1983Higgins and Comerfond, 1974Knight and Rhind, 1975Nakane, 1979Nakane et al, 1980Nelson and Ellenberg, 1982Svigos, 1984Kalen, 1986 6 , 1991 pam, mephobarbital, amobarbital, and ethosuximide. Prevalence figures are as high as 30% but appear to average 10%.…”

Section: Hemorrhagic Diseasementioning

confidence: 99%

“…Table 4 summarizes some of the pharmacokinetics of AEDs drugs during pregnancy. Although it is appealing to equate falling levels of AEDs drugs with increasing seizure frequency, some clinical observations are at variance with this expla- Knight and Rhind, 1975Canger et al, 1982Schmidt et al, 1983Svigos, 1984Otani, 19851956 nation. The increase in seizure frequency occurs mostly in the first trimester (Maroni and Markott, 1969;Knight and Rhind, 1975;Canger et al, 1982;Schmidt et al, 1983) or is evenly distributed throughout pregnancy (Huhmar and Jaruinen, 1961) and not exclusively in the third trimester when the levels have fallen to their lowest.…”

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confidence: 99%

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Pregnancy and Epilepsy

Yerby

1991

Epilepsia

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Women with epilepsy account for approximately 0.5% of all pregnancies. Their pregnancies are high risk because of an increased frequency of maternal seizures, complications of pregnancy, and adverse pregnancy outcomes. The increase in seizure frequency is associated with a progressive decline in antiepileptic drug (AED) levels during pregnancy even with constant dosing. Fetal deaths after a generalized seizure, although rare, have been reported, and a marked decline in fetal heart rate has been demonstrated after such seizures during delivery. AEDs have been implicated in causing a twofold increase in the rate of congenital malformations, a variety of minor physical anomalies, mostly involving the midface, and a neonatal hemorrhagic disorder. The clinician caring for a pregnant woman with epilepsy is therefore faced with a dilemma and must carefully chart a middle ground providing effective seizure control while minimizing fetal exposure to AEDs.

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“…Epilepsy represents one of the most frequent chronic neurological conditions, and its prevalence among pregnant women ranges from 0.3 to 0.6% [1][2][3][4][5][6] . Epilepsy be- [16] , daily doses and balancing the plasma levels of free fraction [17][18][19][20] .…”

Section: Introductionmentioning

confidence: 99%

Fetal Malformations Associated with the Use of Methylphenobarbital and Carbamazepine during Pregnancy

Akšamija¹,

Habek²,

Stanojević³

et al. 2009

Fetal Diagn Ther

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The use of antiepileptic drugs (AEDs) during pregnancy has been associated with an increased risk of major and minor fetal malformations. This paper describes 2 infants with malformations born to epileptic mothers who used AEDs throughout pregnancy. In the first case, the AED used for seizure control was methylphenobarbital, while in the second case the patient had been prescribed carbamazepine. We noted major and minor congenital malformations in both infants exposed in utero to these anticonvulsant drugs. Pregnant women still experience poor obstetrical care because they report to tertiary centers at the end of their pregnancy or when in labor, making it difficult to provide proper medical care for both the infant and the mother.

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Epilepsy and Pregnancy

Cited by 24 publications

References 14 publications

Epilepsy and pregnancy: effect of antiepileptic drugs and lifestyle on birthweight

Epilepsy and pregnancy: effect of antiepileptic drugs and lifestyle on birthweight

Pregnancy and Epilepsy

Fetal Malformations Associated with the Use of Methylphenobarbital and Carbamazepine during Pregnancy

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