The effect of parity on risk of complications in pregnant women with epilepsy: a population‐based cohort study

Danielsson, Kim Christian; Borthen, Ingrid; Gilhus, Nils Erik; Morken, Nils Halvdan

doi:10.1111/aogs.13360

Cited by 9 publications

(13 citation statements)

References 25 publications

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“…However, multivariate analysis found that gravidity was not an independent risk factor and the impact of HDP was only marginally significant. These results are similar to other studies 17 28–30. It was noteworothy that an abnormal quantity of amniotic fluid was the greatest risk factor affecting EmCS, followed by spontaneous seizure or induction of labor.…”

Section: Discussionsupporting

confidence: 91%

Prediction of emergency cesarean section by measurable maternal and fetal characteristics

Guan

Tang

Sun

et al. 2020

Journal of Investigative Medicine

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ObjectiveTo analyze the maternal and fetal factors affecting emergency cesarean section (EmCS) and establish a risk scoring system to quantitatively predict the risk of EmCS.DesignA total of 10,295 pregnant women were enrolled in this study. The influence of maternal and fetal factors on the risk of EmCS was analyzed.Results991 (9.63%) cases of failed vaginal delivery received EmCS. The two main causes of EmCS were fetal distress (67.21%) and abnormal fetal position (14.93%). There were significant differences in 17 maternal and fetal factors between the normal vaginal delivery (NVD) and EmCS groups (p<0.05 for all). Univariate and multivariate regression analyses showed that nine maternal and infant factors were independent risk factors (p<0.05 for all). The major factors were abnormal quantity of amniotic fluid (OR 6.867, 95% CI 4.442 to 10.618), nulliparous (OR 4.336, 95% CI 3.074 to 6.115), induction of labor (OR 5.300, 95% CI 4.514 to 6.224) and abnormal characters of amniotic fluid (OR 3.126, 95% CI 2.708 to 3.608). A risk scoring system (six grades) was established based on those factors which showed high discriminative power. The rate of EmCS was 1.30%, 2.57%, 5.83%, 13.94%, 21.75% and 39.71% in grades 1, 2, 3, 4, 5 and 6, respectively. The area under the curve of the risk scoring system was 0.787, indicating that the regression model of the risk factors had a good predictive ability.ConclusionAn effective risk scoring system has been developed to quantitatively assess the risk of EmCS based on measurable maternal and fetal factors. The system is simple, easy to operate and has good repeatability in clinical practice.

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Section: Discussionsupporting

confidence: 91%

Prediction of emergency cesarean section by measurable maternal and fetal characteristics

Guan

Tang

Sun

et al. 2020

Journal of Investigative Medicine

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“…As preterm birth and caesarean delivery, to some extent, depend upon obstetric management, we strived to disentangle the effects of PsA from obstetric factors and especially parity, by restricting the analysis to first pregnancies to exclude the effect of obstetric management due to earlier pregnancy outcomes . In this analysis we found increased risks of preterm birth.…”

Section: Discussionmentioning

confidence: 99%

Maternal and infant pregnancy outcomes in women with psoriatic arthritis: a Swedish nationwide cohort study

Remaeus

Stephansson

Johansson

et al. 2019

BJOG

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Objective Studies on pregnancy outcomes in psoriatic arthritis (PsA) are scarce and typically of small size. Available studies have reported conflicting results. The aim of this study was to describe maternal and infant pregnancy outcomes among women with PsA compared with women without PsA.Design Nationwide cohort study.Setting Nationwide Swedish registers.Population A total of 41 485 singleton pregnancies in 1997-2014, of which 541 pregnancies were identified with PsA exposure and 40 944 pregnancies were unexposed.Methods By linkage of national health and population register data, we obtained information on individual pregnancies and compared outcomes among pregnancies with PsA and non-PsA pregnancies. Relative risks were estimated by odds ratios (ORs) with 95% CIs using a generalised linear regression model with generalised estimating equations. Adjustments were made for maternal factors and calendar year of birth. Main outcome measures Maternal and infant pregnancy outcomes.Results Pregnancies to women with PsA had increased risks of preterm birth (adjusted OR 1.63; 95% CI 1.17-2.28), elective and emergency caesarean deliveries (adjusted OR 1.47; 95% CI 1.10-1.97 and adjusted OR 1.43; 95% CI 1.08-1.88, respectively) compared with non-PsA pregnancies. No increased risks were observed for pre-eclampsia, stillbirth or other infant outcomes apart from preterm birth. ConclusionThe majority of women with PsA have uneventful pregnancies with respect to adverse outcomes. In the present study, we found increased risks of preterm birth and caesarean delivery compared with non-PsA pregnancies.Keywords Pregnancy outcome, preterm birth, psoriatic arthritis.Tweetable abstract Women with psoriatic arthritis have uneventful pregnancies but are at increased risk of preterm birth and caesarean delivery.

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“…Previous studies have reported that women with AMA had higher incidences of pregnancy complications, such as hypertensive disorders of pregnancy, gestational hypertension, placental disorders, preterm labor, maternal near miss, and maternal death [ 4 – 7 ]. Moreover, research also suggested that the elevated risks of pregnancy complications in AMA may differ by parity [ 8 ], and inconsistent results were reported regarding certain complications [ 9 – 11 ]. For instance, some studies found that the risk of gestational diabetes and hypertensive disorders of pregnancy were increased in both nulliparous and multiparous women with AMA [ 9 ], while in some studies the increased risks for the two complications were not observed in both nulliparas and multiparas [ 10 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Pregnancy complications among nulliparous and multiparous women with advanced maternal age: a community-based prospective cohort study in China

Luo

Fan²,

Luo

et al. 2020

BMC Pregnancy Childbirth

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Background This study aimed to evaluate the incidence rates and risks of pregnancy complications among nulliparous and multiparous women with advanced maternal age (AMA, ≥35 years) in China. Methods We performed a community-based prospective cohort study of 10,171 pregnant women in selected two sub-districts and 11 towns of Liuyang from 2013 to 2015. All subjects were followed up from the first prenatal care (at ≤12 weeks) to delivery, and risks of pregnancy complications were compared by parity and maternal age groups. Results Among nulliparas, women with AMA showed significantly increased risks for gestational hypertension (OR 8.44, 95%CI 1.68–2.88), preeclampsia/eclampsia (OR 9.92, 95%CI 4.87–18.78), premature rupture of membrane (OR 6.84, 95%CI 2.00–17.69), as compared to women in the 20–29-year age group. Among multiparas with AMA, increased risks were found for gestational diabetes mellitus (OR 3.29, 95%CI 1.76–5.94), anemia (OR 1.85, 95%CI 1.25–2.69), polyhydramnios (OR 3.29, 95%CI 1.56–6.64), premature rupture of membrane (OR 5.14, 95%CI 2.12–12.29), and preterm labor (OR 1.89, 95CI 1.42–2.50). Conclusions Women with AMA were associated with increased risks of pregnancy complications, and complications with increased risks differed in nulliparas and multiparas. Women with AMA should be identified as a high-risk group in clinical practice.

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The effect of parity on risk of complications in pregnant women with epilepsy: a population‐based cohort study

Abstract: Second births in women with epilepsy do not represent an increased risk of non-iatrogenic complications, independent of antiepileptic drug use. There is a significant reduction in complications from first to second births in women with epilepsy.

Cited by 9 publications

References 25 publications

Prediction of emergency cesarean section by measurable maternal and fetal characteristics

Prediction of emergency cesarean section by measurable maternal and fetal characteristics

Maternal and infant pregnancy outcomes in women with psoriatic arthritis: a Swedish nationwide cohort study

Pregnancy complications among nulliparous and multiparous women with advanced maternal age: a community-based prospective cohort study in China

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