Affect of seizures during gestation on pregnancy outcomes in women with epilepsy

Objective: To assess whether seizures in women with epilepsy during pregnancy contribute to adverse pregnancy outcomes. Design: A retrospective cross-sectional study. Setting: Taiwan. Patients: This study linked 2 nationwide populationbased data sets: Taiwan's birth certificate registry and the Taiwan National Health Insurance Research Data set. A total of 1016 women with epilepsy were selected who had single births from 2001 to 2003 and who had been diagnosed with epilepsy within 2 years prior to their index delivery, together with 8128 matchedwomenwithout chronic disease as a comparison cohort.Womenwith epilepsy were further stratified into 2 groups for analysis: women who did and did not have seizures during pregnancy. Main Outcome Measures: Low-birth-weight infants, preterm delivery, and infants who are small for gestational age (SGA). Results: Compared with women without epilepsy, epileptic seizures during pregnancy were independently associated with a 1.36-fold (95% confidence interval [CI],1.01-1.88), 1.63-fold (95% CI,1.21-2.19), and 1.37-fold (95% CI, 1.09-1.70) increased risk of low-birthweight infants, preterm delivery, and SGA, respectively, after adjusting for family income and parental and infant characteristics. Further, the risk of SGA increased significantly (odds ratio,1.34; 95% CI,1.01-1.84) for women with seizures during pregnancy compared with women with epilepsy who did not have seizures during pregnancy. Conclusion: We suggest preventing seizures during pregnancy as an essential step to reduce risk of adverse pregnancy outcomes.