Socio-demographic profiles and obstetrics outcomes of pregnant women with epilepsy in a vulnerability State, Brazil

Abstract

Introduction The socio-demographic profile of pregnant women in low- and middle- income countries is characterized by low educational attainment and unemployment, leading to social and economic morbidity. characterized by limited opportunities for education, employment, and marriage, which are strongly related to the stigmatization of the disease. The study of the socio- profile and obstetric outcomes of pregnant women with epilepsy in Alagoas, Brazil, may help understand this scenario and facilitate the development of public policy strategies to reduce local morbidity. Objectives We aimed to describe the sociodemographic profile of pregnant women with epilepsy and obstetric outcomes in Alagoas, Brazil. Methods This cohort study was based on medical records of pregnant women with epilepsy in Brazilian high-risk maternity hospitals from 2008 to 2020. The following data were collected: age, race, education, marital status, occupation, number of pregnancies, delivery, and abortion. The inclusion criteria were pregnant women with and without epilepsy (control group) aged < 40 years. Results The prevalence of PWWE was 0.49% (n = 224/44,917). Cesarean delivery was more frequent in PWWE than in pregnant women without epilepsy (adjusted odds ratio [OR] = 22.0; 95% confidence interval [CI] = 14.35–33.73; p<0,01). Abortion was associated with PWWE (OR adjusted = 1.72; 95% CI = 1.13–2.61; p = 0.01). Pregnant women in the countryside were more likely to develop epilepsy than those born in the capital (OR = 1.55; 95% CI = 1.12–2.14; p <0.01). Conclusion The PWWE socio-demographic profile of the Alagoas had a predominance of brown- colored skin, single status, homemakers, and illiteracy with a high proportion residing in the interior of the state. The obstetrics data show a higher incidence of cesarean deliveries and miscarriages.

Obstetric and neonatal outcomes: Antiseizure medication profile and seizure types in pregnant women in a vulnerability state, Brazil

“…In contrast, the study by de Lima Leite et al (2022), which used the same population cohort as our study, found a statistically signi cant association of miscarriage when comparing PWWE/PWNE; however, we found no association between this outcome and the use or nonuse of ASM [23].…”

Obstetric and neonatal outcomes: Antiseizure medication profile and seizure types in pregnant women in a vulnerability state, Brazil

“…In contrast, the study by de Lima Leite et al (2022), which used the same population cohort as our study, found a statistically signi cant difference in the rates of miscarriage between PWWE/PWNE; however, we found no association between this outcome and the use or non-use of ASM [23].…”

Comparison of Perinatal Outcomes for Women With and Without Epilepsy

“…There were 45 retrospective 3,[5][6][7][8][9][10][13][14][15]19,20,[22][23][24][25] and 21 prospective 11, [16][17][18]21,26,[60][61][62][63][64][65][66][67][68][69][70][71][72][73][74] cohort studies, 9 case-control studies, 4,12,75-81 and 1 cross-sectional study. 82 Sixty-two articles had a low risk of bias 3-11, 13-16, 18-26, 31-40, 42, 45, 46, 48, 50-60, 62-71,74-77,79 and 14 a high risk of bias 12,17,41,43,44,47,49,61,72,73,78,[80][81][82] (eTable 2 in Supplement 1).…”

“…There were 45 retrospective and 21 prospective cohort studies, 9 case-control studies, and 1 cross-sectional study . Sixty-two articles had a low risk of bias and 14 a high risk of bias (eTable 2 in Supplement 1).…”

“…A systematic review and meta-analysis of observational studies investigated the association between maternal epilepsy and reproductive outcomes (with or without ASM exposure) using data from studies from January 1, 1990, to January 21, 2015. However, that study did not investigate many outcomes of clinical interest, including likelihood for offspring congenital conditions or maternal death, and a number of important studies have been conducted since then . One of these studies found an 11-fold increased adjusted odds of maternal death for pregnant women with epilepsy, and another, in contrast to findings of the previous review, found that women with epilepsy had increased odds of preterm birth …”