No increase in adverse pregnancy outcomes for women receiving antiepileptic drugs

Abstract

The objectives of this study were (1) to investigate the incidence of adverse pregnancy outcomes among the epileptic and general populations, including small for gestational age (SGA), low birth weight (LBW) and preterm delivery, using two large-scale nationwide population-based databases, and (2) to compare the risk of these adverse pregnancy outcomes between epileptic women who did and who did not receive antiepileptic drug (AED) treatment during pregnancy. This study used two national datasets: the National Health Insurance Research Dataset and birth certificate registry. We identified a total of 1,182 women who gave birth from 2001 to 2003 in Taiwan who had been diagnosed with epilepsy within the 2 years preceding the index delivery, together with 5,910 matched women as a comparison cohort. Multivariate logistic regression analyses were performed for estimation of risk. We found that approximately 14% of women with epilepsy received AED treatment during gestation. The adjusted odds of LBW, preterm births and SGA for epileptic women not receiving AED treatment during pregnancy were 1.31 (95% CI, 1.02-1.68), 1.35 (95% CI, 1.07-1.71) and 1.23 (95% CI, 1.03-1.46) times that of women without epilepsy, respectively. In contrast, no significant difference in the risk of LBW infants, preterm births and SGA babies was observed between epileptic mothers receiving AED treatment during pregnancy and women without epilepsy. Our study documents an increased risk of adverse pregnancy outcomes for epileptic women who do not receive AED treatment during pregnancy, but none for epileptic women who do receive treatment.

Women treated for epilepsy during pregnancy: outcomes from a nationwide population‐based cohort study

“…On the other hand, recent studies have suggested an increased risk of premature delivery limited to WWE using AED . Nonetheless, there are contradictory results suggesting a higher risk of premature delivery only for WWE without AED .…”

Risk of adverse perinatal outcomes with antithyroid treatment during pregnancy: a nationwide population-based study

“…Of the 2830 women, 703 (24.8%) were prescribed PTU or MMI treatment during pregnancy. Because there is no documented clinical consensus on a defined dosage or time period that qualifies a patient as being ‘on’ or ‘off’ the medication, we defined receiving antithyroid treatment as women prescribed an antithyroid drug for more than 30 days during pregnancy 30 …”

“…Because there is no documented clinical consensus on a defined dosage or time period that qualifies a patient as being 'on' or 'off' the medication, we defined receiving antithyroid treatment as women prescribed an antithyroid drug for more than 30 days during pregnancy. 30 We selected the comparison group from the remaining 208 433 women in the database. We excluded women with a diagnosis of hyperthyroidism anytime during the period 1996-2006 (because Taiwan implemented National Health Insurance in 1995, there are no medical data before 1996).…”

Association Between Epilepsy and Erectile Dysfunction: Evidence from a Population‐Based Study

“…In order to increase the validity of epilepsy diagnoses, we only included epilepsy cases if they had at least three consensus diagnoses of epilepsy within 5 years prior to their index date. This criterion has been used in prior studies [16]. In addition, these epilepsy patients had all been prescribed with antiepileptic medication.…”