PREGNANCY OUTCOMES OF MOTHERS WITH EPILEPSY COMPARED TO MATCHED CONTROLS
Abstract number :
3.133
Submission category :
Year :
2002
Submission ID :
346
Source :
www.aesnet.org
Presentation date :
12/7/2002 12:00:00 AM
Published date :
Dec 1, 2002, 06:00 AM
Authors :
Oormila P. Kovilam, William T. Cahill, Dorothy Pastor, Jane Khoury, David M. Ficker, Jerzy Szaflarski, Michael D. Privitera. Department of Obstetrics and Gynecology, University of Cincinnati Medical Center, Cincinnati, OH; Department of Neurology, Univers
RATIONALE: At the end of this activity, the reader will be able to compare the pregnancy outcomes of mothers with epilepsy (ME) to those of a control population.
A higher incidence of intrauterine growth restriction and fetal distress has been reported in infants of mothers with epilepsy (ME). There have been no recent large studies using matched controls. We sought to compare the outcomes of pregnancies of ME at a university center to matched controls delivered at the same hospital.
METHODS: During the period of 1992 through 2001, there were 100 ME who delivered at the University of Cincinnati Medical Center. Of these, 25 were not on any antiepileptic drug (AED), 52 were on monotherapy and 23 were on more than one AED. Control infants were identified from birth logs and were matched by date of delivery, gestational age, maternal age, method of delivery, gravidity, and presence of major maternal medical complications such as hypertension or diabetes. Analysis of variance was used for analysis of continuous variables while categorical variables were analyzed by chi-square.
RESULTS: The average gestational age at the time of birth in infants of ME was 37.8 weeks. No significant difference was seen across the three groups of infants of ME and controls for birth weight, Apgar scores, or parity. The proportion of prima gravid mothers was significantly greater in ME on no AED compared to the other groups. The presence of 5 minute Apgar score [lt]7 and being small for gestational age were not significantly different across these groups. The use of induction of labor was significantly lower in control mothers than in ME.
CONCLUSIONS: When matched for gestational age, infants of ME with or without AED exposure during pregnancy do not show significant growth restriction when compared to the control infants. Mean Apgar scores and the proportion with 5 minute Apgar scores [lt]7 as measures of neonatal compromise are not significantly different. While the use of induction was greater in ME, the study suggests that infants of ME are likely to have good outcomes based on parameters typically measured at the time of birth.[table1]