Maternal Epilepsy Tied to Increased Maternal Morbidity, Perinatal Mortality and Morbidity

FRIDAY, Aug. 16, 2024 (HealthDay News) -- Women with epilepsy have a considerably higher risk for severe maternal and perinatal outcomes and an increased risk for death during pregnancy and postpartum, according to a study published online Aug. 5 in JAMA Neurology.

Neda Razaz, Ph.D., from the Karolinska Institutet in Stockholm, and colleagues examined associations between maternal epilepsy, antiseizure medication use during pregnancy, and risks for severe maternal and perinatal morbidity and mortality. The analysis included 4.5 million deliveries (1996 through 2017; 4.475 million mothers without epilepsy and 35,283 mothers with epilepsy).

The researchers found that the rate of composite severe maternal morbidity and mortality was higher in women with epilepsy versus those without epilepsy (36.9 versus 25.4 per 1,000 deliveries). Compared with women without epilepsy, women with epilepsy had a significantly higher risk for death (0.05 versus 0.23 deaths per 1,000 deliveries; adjusted odds ratio [aOR], 3.86). Maternal epilepsy was associated with increased odds of severe preeclampsia, embolism, disseminated intravascular coagulation or shock, cerebrovascular events, and severe mental health conditions. Among women with epilepsy, fetuses and infants had higher odds of mortality (aOR, 1.20) and severe neonatal morbidity (aOR, 1.48). Women exposed to antiseizure medicines had higher odds of severe maternal morbidity compared with those unexposed (aOR ,1.24), and their neonates had increased odds of mortality and severe morbidity (aOR, 1.37).

"While most women with epilepsy have uncomplicated pregnancies, there is an urgent need for enhanced counselling, perinatal support, and access to specialized care for safe deliveries in all women with epilepsy," the authors write.

Several authors disclosed ties to the pharmaceutical industry.

Abstract/Full Text