Pregnancy with epilepsy: Obstetric and neonatal outcome of a controlled study

G. Mawer, M. Briggs, G. A. Baker, R. Bromley, H. Coyle, J. Eatock, L. Kerr, U. Kini, L. Kuzmyshcheva, S. B. Lucas, L. Wyatt, J. Clayton-Smith, Siddharth Banka

    Research output: Contribution to journalArticlepeer-review


    Purpose: To determine the influence of epilepsy and its treatment on pregnancy and its outcome. Design: Controlled, observational study. Setting: National Health Service maternity hospitals in Liverpool and Manchester regions. Population: 277 women with epilepsy (WWE) and 315 control women. Methods: WWE were recruited from antenatal clinics. Controls were matched for age and parity but not gestational age. Information was obtained by interview and from clinical records. Main outcome measures: Obstetric complications, mode of delivery, condition of newborn. Results: Distribution of epilepsy syndromes was similar to previous surveys. Most WWE (67%) received monotherapy with carbamazepine, sodium valproate or lamotrigine. Half WWE had no seizures during pregnancy but 34% had tonic clonic seizures. Seizure-related injuries were infrequent. Pregnancies with obstetric complications were increased in women with treated epilepsy (WWTE 45%, controls 33%; p = 0.01). Most had normal vaginal delivery (WWTE 63%, controls 61%; p = 0.65). Low birth weight was not increased (WWTE 6.2%, controls 5.2%; p = 0.69). There were more major congenital malformations (MCM) (WWTE 6.6%, controls 2.1%; p = 0.02) and fetal/infant deaths (WWTE 2.2%, controls 0.3%; p = 0.09). Amongst monotherapies MCM prevalence was highest with valproate (11.3%; p = 0.005). Lamotrigine (5.4%; p = 0.23) and carbamazepine (3.0%; p = 0.65) were closer to controls (2.1%). There was no association between MCM and dose of folic acid pre-conception. Conclusion: MCM were more prevalent in the babies of WWTE particularly amongst those receiving sodium valproate. © 2009 British Epilepsy Association.
    Original languageEnglish
    Pages (from-to)112-119
    Number of pages7
    JournalSeizure: European Journal of Epilepsy
    Issue number2
    Publication statusPublished - Mar 2010


    • Antiepileptic drugs
    • Epilepsy
    • Pregnancy outcome
    • Teratogenicity


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