title: Obstetric outcome in women with epilepsy: a hospital-based, retrospective study.
abstract: OBJECTIVE
  To report the complications during pregnancy and delivery in women with epilepsy, compared with a control group without epilepsy, with special focus on potential risk factors, such as epilepsy severity and dosage of antiepileptic drugs.
  
  
  METHODS
  Hospital-based retrospective study.
  
  
  METHODS
  Data from pregnancy notification forms and hospital case records.
  
  
  METHODS
  Women with a past or present history of epilepsy (n = 205) delivered in Bergen, Norway, in the period 1999-2006, and a matched control group of women (n = 205) without epilepsy.
  
  
  METHODS
  Data were compared and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated by multiple logistic regression models.
  
  
  METHODS
  Pre-eclampsia (mild and severe), gestational hypertension, vaginal bleeding (early and late), caesarean section, vaginal operative delivery, postpartum haemorrhage and major malformations.
  
  
  RESULTS
  Women with epilepsy using antiepileptic drugs had an increased risk of severe pre-eclampsia (OR, 5.0; 95% CI, 1.3-19.9), bleeding in early pregnancy (OR, 6.4; 95% CI, 2.7-15.2), induction (OR, 2.3; 95% CI, 1.2-4.3) and caesarean section (OR, 2.5; 95% CI, 1.4-4.7) adjusted for maternal age, parity, education, smoking, medical conditions and body mass index ≥30 kg/m(2) . There was also an increased risk of malformations in the offspring (OR, 7.1; 95% CI, 1.4-36.6). Women without antiepileptic drug use had increased risks of forceps delivery and preterm birth. Active epilepsy (seizures during the last 5 years) versus nonactive epilepsy did not discriminate for any of these complications; 84.5% of women with epilepsy and antiepileptic drug use were using folate.
  
  
  CONCLUSIONS
  Women with epilepsy using antiepileptic drugs had an increased risk of pregnancy and delivery complications, whereas women not using antiepileptic drugs had few complications. Seizures, high doses of antiepileptic drugs, obesity and lack of folate could not explain these increased risks.
authors.affiliation: Department of Clinical Medicine, University of Bergen, Norway. ingrid.borthen@med.uib.no
authors.forename: I
authors.initials: I
authors.lastname: Borthen
authors.forename: M G
authors.initials: MG
authors.lastname: Eide
authors.forename: A K
authors.initials: AK
authors.lastname: Daltveit
authors.forename: N E
authors.initials: NE
authors.lastname: Gilhus
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects*; D015992:Body Mass Index; D016022:Case-Control Studies; D002585:Cesarean Section / Q000009:adverse effects; D016001:Confidence Intervals; D036861:Delivery, Obstetric / Q000009:adverse effects* / Q000706:statistics & numerical data; D004827:Epilepsy / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000209:etiology; D007231:Infant, Newborn; D007297:Inpatients; D016015:Logistic Models; D009664:Norway / Q000453:epidemiology; D009765:Obesity / Q000150:complications; D016017:Odds Ratio; D006473:Postpartum Hemorrhage / Q000209:etiology; D011225:Pre-Eclampsia / Q000209:etiology; D011247:Pregnancy; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012494:Sampling Studies; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects
chemical_list: D000927:Anticonvulsants