(Ivanhoe Newswire) -- Women with epilepsy who have seizures during
pregnancy appear more likely to give birth to pre-term, small or
low-birth-weight babies than women without epilepsy, according to a new report.
"While approximately 40 percent of the 18 million women with epilepsy in the
world are of childbearing age,” Yi-Hua Chen, Ph.D., of Tai Pei Medical
University, Taiwan, and colleagues were quoted as saying, “managing maternal
epilepsy and monitoring the health of the developing fetus remain some of the
most perplexing and engaging issues in the fields of neurology and obstetrics."
Researchers used data from the Taiwan National Health Insurance Research Data
set, analyzing records from 1,016 women with epilepsy who gave birth between
2001 and 2003. Of these, 503 had seizures during pregnancy and 513 did not. A
control group of 8,128 women who were the same age and gave birth during the
same years but did not have epilepsy or any other chronic disease were selected
for comparison.
Women who had seizures during pregnancy were 1.36 times more likely to have a
low-birth-weight baby, 1.63 times more likely to give birth before 37 weeks and
had a 1.37 times greater risk of having a baby who was small for gestational
age. Compared with women who had epilepsy but did not have seizures, the odds of
women who had seizures during pregnancy of having a baby who was small for
gestational age were 1.34 times greater.
"Our study . . . suggests that it is the seizures themselves that seem to
contribute greatly to the increased risk,” said the researchers. “For women who
remained seizure-free throughout pregnancy, null or mild risk was identified
compared with unaffected women."
There are several possible explanations for the association between seizures and
adverse pregnancy outcomes. Trauma caused by a woman's seizures could rupture
fetal membranes, increasing risk of infection and early delivery. Tension and
acute injury may result from uterine contractions that occur during seizures.
However, additional research is needed to understand how seizures interfere with
fetal development.
"Neonates born pre-term, of low birth weight and small for gestational age may
be predisposed to diseases during infancy and later life, highlighting the
significance of proper intervention strategies for prevention," the authors
wrote.
Prevention strategies could include helping women control seizures for a period
of time before pregnancy, assisting them in sleeping better, providing education
about the risks of seizures while pregnant and teaching improved strategies for
coping with stress.
SOURCE: Archives of Neurology, August 2009
