Prevalence of epilepsy in Saudi pregnant women and possible effects of anti-epileptic drugs on pregnancy outcomes

Abstract

Objectives: To determine the prevalence of epilepsy in Saudi pregnant women and estimate the frequency of seizure types in suffering individuals using different anti-epileptic drug modalities. It also aimed to report the teratogenic effects of anti-epileptic drugs as observed in neonates. Methods: This prospective study was conducted at King Fahd University Hospital from June 2018 to Original Articles July 2019. Sixty-eight pregnant women diagnosed with epilepsy were included in this study. Seizure types and their frequencies were recorded along with anti-epileptic drug therapies and their association with fetal/neonatal malformations. Results: Out of 68 epileptic pregnant females, 30)44.1%(experienced focal seizures and 38)55.9%(experienced generalized seizures. Thirty-nine)57.3%(received monotherapy, 21)30.9%(received polytherapy and 8)11.8%(did not take antiepileptic drugs during pregnancy. Thirty-six)52.9%(patients experienced no change in seizure frequency during pregnancy, 19)27.9%(experienced increase in seizure frequency and 13)19.1%(showed decreased seizure frequency. The pregnancy outcomes analysis showed 2)2.9%(intrauterine fetal deaths, whereas 4)4.9%(neonates showed facial and/or organ malformations. Conclusion: The frequency of seizures was found to increase in only 27.9% of the pregnant women in the sample. Malformation and mortality rates were higher in fetuses/neonates of patients with generalized seizures. It was observed that for the patient group using monotherapy, the rate of healthy babies was higher than that of the group using polytherapy.

Fármacos antiepilépticos usados en el embarazo y sus consecuencias sobre los resultados fetales: una revisión de la literatura

“…De los 37 estudios seleccionados para la síntesis cualitativa, uno fue publicado en 2022 9 , tres en 2021 [10][11][12] , seis en 2020 [13][14][15][16][17][18] , siete en 2019 [19][20][21][22][23][24][25] , siete en 2018 [26][27][28][29][30][31][32] , nueve en 2017 6,[33][34][35][36][37][38][39][40] y cuatro en 2016 [41][42][43][44] , proviniendo de 14 países repartidos por Asia, Europa, América del Norte y Oceanía.…”

Antiseizure medications use during pregnancy and congenital malformations: A retrospective study in Saudi Arabia

“…The malformation rate observed in the presented study was comparable to that reported in other studies. In a recent study in Saudi Arabia which included 68 women of epilepsy, congenital malformation was observed in 4 (5.9%) neonates ( AlSheikh, 2020 ). A study from the United Arab Emirates (UAE) that included 179 pregnancies of women with epilepsy observed 13 (7.26%) birth defects ( Alsaadi et al, 2020 ).…”

“…Adverse drug effects on the fetuses can occur, such as abortion, low birth weight, preterm birth, congenital malformations, delayed postnatal cognitive development and postnatal behavioral complications ( Tomson and Battino, 2012 ). The estimated prevalence of congenital malformations in children of women with epilepsy in Saudi Arabia is 2.5–5.9% ( Albunyan and Abo-Talib, 1999 , AlSheikh, 2020 ).…”

“…However, there is no national pregnancy registry in Saudi Arabia. In fact, there are only few studies in Saudi Arabia on outcomes in pregnant women with epilepsy ( Albunyan and Abo-Talib, 1999 , Algahtani et al, 2019 , AlSheikh, 2020 ).…”

Knowledge regarding teratogens among women of childbearing age at a large tertiary care center in Saudi Arabia

“…Some of the comorbidities that pose a teratogenic risk include gestational diabetes mellitus which is associated with higher risk of congenital malformation,[ 6 7 8 ] thyroid related diseases and medications[ 9 10 ] and epilepsy medications. [ 11 12 13 ] Awareness of women showed insufficient knowledge regarding the teratogenicity of gestational diabetes mellitus,[ 14 ] thyroid diseases and medications[ 15 ] and epileptic medications. [ 16 17 ] In general, medication use and safety during pregnancy is a highly debatable subject.…”