title: Obstetric and birth outcomes in pregnant women with epilepsy: A hospital-based study.
abstract: BACKGROUND
  In addition to changes in seizure frequency, pregnant women with epilepsy (WWE) are at increased risk of complications during pregnancy or delivery. In the absence of a nationwide WWE registry, hospital-based studies may provide important information regarding current management and outcomes in these patients.
  
  
  OBJECTIVE
  The aims of this study were to determine changes in seizure frequency, and pregnancy and birth outcomes among pregnant WWE.
  
  
  METHODS
  We conducted a retrospective review of medical records of pregnant patients with epilepsy, who obtained medical care (from 2006 to 2011) at one of the general hospitals in the North-Eastern State of Malaysia. Data were collected for seizure frequency before and during the pregnancy, concurrent medications, pregnancy complications, and neonatal outcomes.
  
  
  RESULTS
  We reviewed records of 25 patients with a total of 33 different pregnancies. All patients were treated with antiepileptic medications during their pregnancies, with 42% monotherapy and 58% polytherapy. Seizure frequency decreased in 5 (15.2%), increased in 18 (54.5%) and unchanged in 10 (30.3%) cases of pregnancies. Pregnancy complications were anemia, gestational diabetes mellitus, gestational hypertension, intrauterine growth retardation, premature rupture of membrane, and vaginal bleeding. Preterm deliveries were recorded in 11 (33.3%) infants.
  
  
  CONCLUSIONS
  In our setting, many patients were being on polytherapy during their pregnancies. This underscores the need for planned pregnancies so that antiepileptic medications can be optimized prior to pregnancy.
authors: Department of Pharmacy, Hospital Raja Perempuan Zainab II, Jalan Hospital, 15586 Kota Bharu, Malaysia.
authors: Noor Haslina
authors: NH
authors: Othman
authors: Ab Fatah
authors: AF
authors: Ab Rahman
keywords: Epilepsy; outcomes; pregnancy; women