The impact of maternal epilepsy on perinatal outcome in singleton gestations

Objective: We sought to evaluate perinatal outcomes in women with epilepsy. Methods: We performed a retrospective cohort study between 2007 and 2014, at a tertiary, university-affiliated medical center. All women with singleton gestation who delivered during the study period were included, except for pregnancies in which fetuses with chromosomal or structural anomalies were diagnosed. Perinatal outcome was compared between two groups: women diagnosed with epilepsy and women without epilepsy. Results: Out of 62,102 deliveries during the study period, 61,455 met the inclusion criteria, of whom 206 (0.3%) had epilepsy. The only difference found in maternal demographics was higher rate of nulliparity in the epilepsy group (p =.02). As for maternal adverse outcome, higher rates of placental abruption and longer postpartum admission were found in women with epilepsy (p =.02 and p <.001, respectively). Comparing neonatal outcomes between the two groups, higher rates of neonatal intensive care unit admission (16.5 versus 9.2%), seizures (1.9 versus 0.4%), transient tachypnea of the newborn (2.4 versus 1.0%) and respiratory distress syndrome (1.9 versus 0.4%) were significantly higher to newborns of women with epilepsy (p <.05 for all). On multivariable logistic regression, epilepsy was found to be independently and significantly associated with placental abruption (OR 4.04, 95%CI 1.27–12.83, p =.02), neonatal intensive care unit (NICU) admissions (OR 1.84, 95%CI 1.25–2.70, p =.002), seizures (OR 4.33, 95%CI 1.60–11.77, p =.004), transient tachypnea of the newborn (OR 2.47, 95%CI 1.005–6.05, p =.049) and respiratory distress syndrome (OR 7.16, 95%CI 2.47–20.76, p <.001). Conclusions: Epilepsy in pregnant women is associated with adverse perinatal outcomes, including neonatal seizures, placental abruption and respiratory problems.