Obstetrical Outcomes in Patients with Epilepsy in a Canadian Tertiary Care Center
Abstract number :
2.163
Submission category :
4. Clinical Epilepsy / 4E. Women's Issues
Year :
2022
Submission ID :
2205076
Source :
www.aesnet.org
Presentation date :
12/4/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:27 AM
Authors :
Sharon Ng, BA – University Health Network; Julien Hebert, MDCM, MSc, FRCPC – 2nd Author, University of Toronto; Yajur Iyengar, BSc – 3rd Author, University of Toronto; Jenny Liao, BSc – Fourth Author, University of Toronto; John Snelgrove, MD, MSc, FRCSC – Fifth Author (or Second Last Author), Mount Sinai Hospital; Esther Bui, MD, FRCPC – Last Author, UHN
This abstract has been invited to present during the Broadening Representation Inclusion and Diversity by Growing Equity (BRIDGE) poster session
Rationale: There is currently a paucity of published data on the management and obstetrical outcomes of pregnant patients with epilepsy in Canada. Investigating obstetrical outcomes of patients with epilepsy receiving specialized obstetrical care can inform the importance of more targeted interventions in this patient cohort.
Methods: We retrospectively identified pregnancies by people with epilepsy seen in an urban Canadian tertiary care center between January 1, 2005, and November 20, 2020. We described demographics, folic acid use, and obstetrical outcomes. We reviewed the patients’ medical records to identify maternal complications pre-pregnancy and during pregnancy, labor, and delivery. This study was approved by the institution’s Review Ethics Board.
Results: We identified 289 pregnancies from 236 patients. Median age at pregnancy was 33 years old (range: 17-51). Participants reported to be of: European (36.7%), African (4.2%), East Asian (5.2%), South Asian/Pakistani (10.0%), Latin American (5.2%), Middle Eastern (0.7%), and Indigenous (1.0%) descents (37.4% not reported). Fifty-three percent were first pregnancies. Pre-conception folic acid supplementation was taken in 64% of pregnancies, compared to 24% without supplementation (12% unknown pre-conception folic acid use). The rates of gestational complications were: 8.9% hypertension (CI95%: 5.8-12.8, Canadian average: 7.0%, p=0.19), 4.9% diabetes (CI95%: 5.8-12.8, Canadian average: 5.5%, p=0.79), and 23.3% antepartum bleeding (CI95%: 18-29%, Canadian average: 25.0%, p=0.58). There were no cases of maternal mortality. Ninety-seven percent of pregnancies resulted in a viable live birth, 2% in spontaneous abortion (CI95%: 0.7-4.4%, Canadian average: 10%, p< 0.01), and 1% in stillbirth (CI95%: 0.0-2.5%, Canadian average: 0.8%, p >0.99). Forty-six percent of pregnancies delivered by cesarean section (CI95%: 36.8-48.5%, Canadian average: 28.2%; p= < 0.001), of which 30.8% were elective. Peripartum complications were rare (n=24, 9%) and mostly minor. Two patients (0.7%) experienced peripartum seizures and eight patients required intervention for post-partum hemorrhage.
Clinical Epilepsy