Women with epilepsy ‘at greater risk of complications with pregnancy’

A new study has added to the body of evidence demonstrating the increased health risks experienced by women with epilepsy.

Published in JAMA Neurology, the research from the Harvard TH Chan School of Public Health in Boston examined obstetric outcomes including maternal death, caesarean delivery, length of stay, preeclampsia, preterm labor and stillbirth in a retrospective study of pregnant women identified through US hospitalisation records from 2007 to 2011.

Nearly 4.2 million delivery-related discharges were included in the study group, with 14,151 of these being women with epilepsy.

It was observed that women with epilepsy had a risk of death during delivery of 80 mortalities per 100,000 pregnancies – much higher than the ratio of six deaths in 100,000 pregnancies seen among women without epilepsy.

Although this data lacked information about the ultimate causes of death during delivery, the evidence indicated that women with epilepsy were at increased risk of a variety of adverse outcomes, including preeclampsia, preterm labour and stillbirth.

This patient group also generally required greater amounts of care, including an increased risk of caesarean delivery and prolonged hospital stay, regardless of delivery method.

The authors concluded: “Regardless of the specific cause, the point that women recorded as having epilepsy have an increased risk of mortality remains a clinically relevant message suggesting that increased attention should be paid. Future research is needed to determine the specific causes of mortality and how interventions might improve outcomes.”

However, they also pointed out the fact that the risk of a mother dying during delivery remains extremely low even among women with epilepsy.

Further research is now needed to understand the mechanisms underlying these risks in order to devise specific ways of minimising the issue and ensuring women with epilepsy are no longer subject to this danger.

Posted by Steve Long

Scientific abstract: http://archneur.jamanetwork.com/article.aspx?articleid=2368723

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