The impact of epilepsy and antiseizure medications on pregnancy and neonatal outcomes: A nationwide cohort study
Abstract Purpose Our objective was to assess the adverse outcomes during pregnancy, as well as for the fetus and neonates, in women with epilepsy, both with and without the use of antiseizure medications (ASMs). Methods A cohort of singleton pregnancies between January 1, 2004 and December 31, 2014...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-12-01
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| Series: | Brain and Behavior |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/brb3.3287 |
| _version_ | 1827366567736770560 |
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| author | Cheng‐Yen Kuo Chang‐Fu Kuo Lai‐Chu See Meng‐Jiung Chiou Po‐Cheng Hung Jainn‐Jim Lin Kuang‐Lin Lin Huei‐Shyong Wang I‐Jun Chou |
| author_facet | Cheng‐Yen Kuo Chang‐Fu Kuo Lai‐Chu See Meng‐Jiung Chiou Po‐Cheng Hung Jainn‐Jim Lin Kuang‐Lin Lin Huei‐Shyong Wang I‐Jun Chou |
| author_sort | Cheng‐Yen Kuo |
| collection | DOAJ |
| description | Abstract Purpose Our objective was to assess the adverse outcomes during pregnancy, as well as for the fetus and neonates, in women with epilepsy, both with and without the use of antiseizure medications (ASMs). Methods A cohort of singleton pregnancies between January 1, 2004 and December 31, 2014 was identified using the Taiwan National Health Database. The pregnancies were categorized into ASM exposure, ASM nonexposure, and control (consisting of women without an epilepsy diagnosis) groups. We recorded adverse outcomes in neonates and documented pregnancy complications. The generalized estimating equation with logit link was used to estimate adjusted odds ratios. Results There were 629 singleton pregnancies in the group exposed to ASMs, 771 in the epilepsy group without ASM exposure, and 2,004,479 in the control group. Women with epilepsy had a significantly higher risk of puerperal cerebrovascular diseases (adjusted odds ratios in the exposure and nonexposure groups = 54.46 and 20.37, respectively), respiratory distress syndrome (5.1 and 2.99), mortality (3.15 and 3.22), sepsis (2.67 and 2.54), pregnancy‐related hypertension (1.71 and 1.8), preeclampsia (1.87 and 1.79), cesarean delivery (1.72 and 2.15), and preterm labor (1.38 and 1.56). The use of ASMs may increase the risk of eclampsia (adjusted odds ratio = 12.27). Compared to controls, fetuses/neonates born to women with epilepsy had a higher risk of unexplained stillbirth (adjusted odds ratios in the exposure and nonexposure groups = 2.51 and 2.37, respectively), congenital anomaly (1.37 and 1.33), central nervous system malformation (3.57 and 2.25), low birth weight (1.90 and 1.97), and a low Apgar score at 5 min (2.63 and 1.3). The use of ASMs may introduce an additional risk of small for gestational age; the adjusted odds ratio was 1.51. Conclusion Women with epilepsy, irrespective of their exposure to ASMs, had a slightly elevated risk of pregnancy and perinatal complications. Puerperal cerebrovascular diseases may be a hidden risk for women with epilepsy. |
| first_indexed | 2024-03-08T08:53:25Z |
| format | Article |
| id | doaj.art-72f7da08bc8d44e0b534ca1438581d1c |
| institution | Directory Open Access Journal |
| issn | 2162-3279 |
| language | English |
| last_indexed | 2024-03-08T08:53:25Z |
| publishDate | 2023-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Brain and Behavior |
| spelling | doaj.art-72f7da08bc8d44e0b534ca1438581d1c2024-02-01T07:45:36ZengWileyBrain and Behavior2162-32792023-12-011312n/an/a10.1002/brb3.3287The impact of epilepsy and antiseizure medications on pregnancy and neonatal outcomes: A nationwide cohort studyCheng‐Yen Kuo0Chang‐Fu Kuo1Lai‐Chu See2Meng‐Jiung Chiou3Po‐Cheng Hung4Jainn‐Jim Lin5Kuang‐Lin Lin6Huei‐Shyong Wang7I‐Jun Chou8Division of Pediatric Neurology Chang Gung Memorial Hospital Taoyuan TaiwanDivision of Rheumatology, Allergy and Immunology Chang Gung Memorial Hospital Taoyuan TaiwanDivision of Rheumatology, Allergy and Immunology Chang Gung Memorial Hospital Taoyuan TaiwanCenter for Artificial Intelligence in Medicine Chang Gung Memorial Hospital Taoyuan TaiwanDivision of Pediatric Neurology Chang Gung Memorial Hospital Taoyuan TaiwanDivision of Pediatric Neurology Chang Gung Memorial Hospital Taoyuan TaiwanDivision of Pediatric Neurology Chang Gung Memorial Hospital Taoyuan TaiwanDivision of Pediatric Neurology Chang Gung Memorial Hospital Taoyuan TaiwanDivision of Pediatric Neurology Chang Gung Memorial Hospital Taoyuan TaiwanAbstract Purpose Our objective was to assess the adverse outcomes during pregnancy, as well as for the fetus and neonates, in women with epilepsy, both with and without the use of antiseizure medications (ASMs). Methods A cohort of singleton pregnancies between January 1, 2004 and December 31, 2014 was identified using the Taiwan National Health Database. The pregnancies were categorized into ASM exposure, ASM nonexposure, and control (consisting of women without an epilepsy diagnosis) groups. We recorded adverse outcomes in neonates and documented pregnancy complications. The generalized estimating equation with logit link was used to estimate adjusted odds ratios. Results There were 629 singleton pregnancies in the group exposed to ASMs, 771 in the epilepsy group without ASM exposure, and 2,004,479 in the control group. Women with epilepsy had a significantly higher risk of puerperal cerebrovascular diseases (adjusted odds ratios in the exposure and nonexposure groups = 54.46 and 20.37, respectively), respiratory distress syndrome (5.1 and 2.99), mortality (3.15 and 3.22), sepsis (2.67 and 2.54), pregnancy‐related hypertension (1.71 and 1.8), preeclampsia (1.87 and 1.79), cesarean delivery (1.72 and 2.15), and preterm labor (1.38 and 1.56). The use of ASMs may increase the risk of eclampsia (adjusted odds ratio = 12.27). Compared to controls, fetuses/neonates born to women with epilepsy had a higher risk of unexplained stillbirth (adjusted odds ratios in the exposure and nonexposure groups = 2.51 and 2.37, respectively), congenital anomaly (1.37 and 1.33), central nervous system malformation (3.57 and 2.25), low birth weight (1.90 and 1.97), and a low Apgar score at 5 min (2.63 and 1.3). The use of ASMs may introduce an additional risk of small for gestational age; the adjusted odds ratio was 1.51. Conclusion Women with epilepsy, irrespective of their exposure to ASMs, had a slightly elevated risk of pregnancy and perinatal complications. Puerperal cerebrovascular diseases may be a hidden risk for women with epilepsy.https://doi.org/10.1002/brb3.3287antiseizure medications (ASMs)epilepsyoutcomepregnancywomen with epilepsy |
| spellingShingle | Cheng‐Yen Kuo Chang‐Fu Kuo Lai‐Chu See Meng‐Jiung Chiou Po‐Cheng Hung Jainn‐Jim Lin Kuang‐Lin Lin Huei‐Shyong Wang I‐Jun Chou The impact of epilepsy and antiseizure medications on pregnancy and neonatal outcomes: A nationwide cohort study Brain and Behavior antiseizure medications (ASMs) epilepsy outcome pregnancy women with epilepsy |
| title | The impact of epilepsy and antiseizure medications on pregnancy and neonatal outcomes: A nationwide cohort study |
| title_full | The impact of epilepsy and antiseizure medications on pregnancy and neonatal outcomes: A nationwide cohort study |
| title_fullStr | The impact of epilepsy and antiseizure medications on pregnancy and neonatal outcomes: A nationwide cohort study |
| title_full_unstemmed | The impact of epilepsy and antiseizure medications on pregnancy and neonatal outcomes: A nationwide cohort study |
| title_short | The impact of epilepsy and antiseizure medications on pregnancy and neonatal outcomes: A nationwide cohort study |
| title_sort | impact of epilepsy and antiseizure medications on pregnancy and neonatal outcomes a nationwide cohort study |
| topic | antiseizure medications (ASMs) epilepsy outcome pregnancy women with epilepsy |
| url | https://doi.org/10.1002/brb3.3287 |
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