Women with Epilepsy who are Overweight Should Be Closely Monitored in Pregnancy to Avoid Complications

Women with epilepsy who are overweight are at a higher risk of developing complications during pregnancy and delivery, according to a new study published in the scientific journal, Epilepsia.

The authors state that these women should be regarded as a high-risk group, and that they should be referred to a nutritionist both before an antiepileptic drug (AED) is started and when a pregnancy is planned.

For the study, which was based on the Norwegian Mother and Child Cohort Study linked to the Medical Birth Registry of Norway, researchers led by Dr Marte Bjørk, at the University of Bergen, analysed the birth records of almost 100,000 pregnant women across Norway, from between 1999 and 2008.

A total of 706 women had a diagnosis of epilepsy and, among them, 259 were classed as overweight (having a body mass index (BMI) of 25 or more) and 416 were classed as ‘normal’ weight. Of the women who did not have epilepsy, 30,516 were overweight and 67,977 were normal weight.

The researchers noted from their subjects that women with epilepsy were more likely to be overweight than those without epilepsy. Looking specifically at the women who were overweight, they discovered that those with epilepsy had an increased risk of many birth complications (e.g. needing a caesarean section, having excessive bleeding during delivery, having a smaller than normal baby and developing depression and anxiety) compared to those without epilepsy.

The team then compared women with epilepsy who were overweight and normal weight. Here, they found that those who were overweight had a greater risk of needing a caesarean section, of having high blood pressure linked to pregnancy and of preeclampsia. The babies of the women with epilepsy who were overweight also had a higher risk of being transferred to the neonatal ward.

The authors recommend that blood sugar and signs of preeclampsia, anxiety and depression be more closely monitored in women with epilepsy who are overweight. They also suggest that additional ultrasounds should be considered for these women, to assess any growth abnormalities in the baby.

Author: Dr Özge Özkaya

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