Systematic Review of the Effects of Gestational Seizures on Short-Term Obstetric Outcomes in Women with Epilepsy
Abstract number :
1.241
Submission category :
4. Clinical Epilepsy / 4E. Women's Issues
Year :
2023
Submission ID :
194
Source :
www.aesnet.org
Presentation date :
12/2/2023 12:00:00 AM
Published date :
Authors :
Presenting Author: Andrea Clapp, MD – Maine Medical Center
David Taplinger, MD, MD – Resident Program Director, Maine Medical Center
Rationale:
Epilepsy, characterized by a tendency to have recurrent unprovoked seizures, is common affecting over half of a million women of childbearing age in the USA 1. Epilepsy is a risk factor for poor pregnancy outcomes.1 The majority of prior studies compare pregnant patients with epilepsy to pregnant patients who do not have epilepsy. It is thought that seizures during pregnancy are associated with fetal hypoxemia and asphyxia.1 Although the literature supports that women with epilepsy are at greater risk for poor obstetrical outcomes, it is not clear if women with epilepsy who have seizures during pregnancy are at a greater risk for poor obstetric outcomes in comparison to pregnant women with epilepsy who do not have seizures. The intent of this review is to understand the effect of gestational seizures on obstetric outcomes.
Methods:
The terms “seizures,” “pregnancy” and “outcomes” were searched on PUBMED. “Seizure during pregnancy and outcome” on PUBMED was then searched. Duplicate studies, case reports, and reviews were removed. Articles were excluded if they did not specifically compare the obstetric outcomes between women with epilepsy who had gestational seizures and pregnant women with epilepsy who did not have gestational seizures. Retrospective and prospective cohort studies and descriptive studies that focused on evaluating obstetric outcomes either at delivery or within one year of delivery were included. The data from 28 articles met inclusion criteria for this review.
Results: There was conflicting evidence of the effect of gestational seizures on birth weight as multiple studies demonstrated an increased incidence of low birth weight, preterm delivery, and small for gestational age among the groups who had gestational seizures. Several other studies did not find this association. Several studies did not find any significant difference across poor obstetric and neonatal outcomes or congenital malformations between women with epilepsy who had gestational seizures. Maternal death and fetal death related to gestational seizures were rare events. Most women with epilepsy who had seizures during pregnancy had normal obstetric outcomes across multiple studies.
Conclusions: Overall, epilepsy is associated with adverse obstetric outcomes but most pregnant patients with epilepsy have normal short-term obstetric outcomes despite seizures during pregnancies. Maternal and fetal death attributed to seizures is rare. There is some evidence in the literature to suggest that pregnant patients with epilepsy who have gestational seizures have increased risk of preterm delivery, small for gestational age, and low birth weight in comparison to women with epilepsy who do not have gestational seizures. More research is needed to improve our understanding of the effects of gestational seizures on obstetric outcomes in pregnancy.
1Li Y, Meador KJ. Epilepsy and Pregnancy. Continuum (Minneap Minn). 2022 Feb 1;28(1):34-54. doi: 10.1212/CON.0000000000001056. PMID: 35133310; PMCID: PMC9642109.
Funding: None
Clinical Epilepsy