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Yi-Hua Chen, PhD; Hung-Yi Chiou, PhD; Herng-Ching Lin, PhD; Hsiu-Li Lin, MD

Arch Neurol. 2009;66(8):979-984.

Objective  To assess whether seizures in women with epilepsy during pregnancy contribute to adverse pregnancy outcomes.

Design  A retrospective cross-sectional study.

Setting  Taiwan.

Patients  This study linked 2 nationwide population-based data sets: Taiwan's birth certificate registry and the Taiwan National Health Insurance Research Data set. A total of 1016 women with epilepsy were selected who had single births from 2001 to 2003 and who had been diagnosed with epilepsy within 2 years prior to their index delivery, together with 8128 matched women without chronic disease as a comparison cohort. Women with epilepsy were further stratified into 2 groups for analysis: women who did and did not have seizures during pregnancy.

Main Outcome Measures  Low-birth-weight infants, preterm delivery, and infants who are small for gestational age (SGA).

Results  Compared with women without epilepsy, epileptic seizures during pregnancy were independently associated with a 1.36-fold (95% confidence interval [CI], 1.01-1.88), 1.63-fold (95% CI, 1.21-2.19), and 1.37-fold (95% CI, 1.09-1.70) increased risk of low-birth-weight infants, preterm delivery, and SGA, respectively, after adjusting for family income and parental and infant characteristics. Further, the risk of SGA increased significantly (odds ratio, 1.34; 95% CI, 1.01-1.84) for women with seizures during pregnancy compared with women with epilepsy who did not have seizures during pregnancy.

Conclusion  We suggest preventing seizures during pregnancy as an essential step to reduce risk of adverse pregnancy outcomes.

Author Affiliations: Schools of Public Health (Drs Chen and Chiou) and Health Care Administration (Dr H.-C. Lin), Taipei Medical University; and the Department of Neurology, General Cathay Hospital, Sijhih Branch, Taipei, Taiwan (Dr H.-L. Lin).

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