[P2-80] Pregnancy Related Cerebrovascular Disease, Mortality, Morbidity and Fetal-neonatal Outcomes in Women with Epilepsy: a Nationwide Population-based Study
[Introduction] Approximately 0.3% to 0.5% of all pregnancies occur in women with epilepsy. They have an increased risk for puerperal mortality and adverse maternal and fetal-neonatal outcomes than women in the general population. Cerebrovascular disorders accounts for 12 % of death among pregnant women. However, these risks have not been quantified in large population-based patients with epilepsy in Asia.
[Objective] To estimate the risks of cerebrovascular disease, mortality, maternal and fetal-neonatal outcomes in women with epilepsy at the time of delivery, compared with those without epilepsy.
[Methodology] This is a population-based cohort study using the Taiwan National Health Insurance database linked to the National Birth Registry and National Death Registry.
[Results] We identified 2,350,339 singleton pregnancies between 2001 and 2012, of which 7,660 (0.3%) were delivered by mothers with pre-existing epilepsy before pregnancy. Pregnancies in epilepsy patients were associated with an adjusted odds ratio (OR; 95% confidence intervals [CIs]) of 18.79 (15.5-22.7) for puerperal cerebrovascular disorders, 10.95(2.63-45.5) for aneurysm, 3.87 (1.44-10.4) for maternal death within 30 days, and 1.57 (1.28-1.93) for stillbirth. Perinatal outcome was compromised in offspring of mothers with epilepsy, with an OR (95% CIs) of 1.37 (1.27-1.47) for low birth weight, 1.35 (1.26-1.44) for prematurity, 1.33 (1.16-1.53) and 1.43 (1.10-1.87) for a low 1-minute and 5-minute Apgar scores.
[Conclusions] Puerperal cerebrovascular disease and mortality are increased in mothers with epilepsy, whose fetal-neonatal outcomes are compromised.
[Objective] To estimate the risks of cerebrovascular disease, mortality, maternal and fetal-neonatal outcomes in women with epilepsy at the time of delivery, compared with those without epilepsy.
[Methodology] This is a population-based cohort study using the Taiwan National Health Insurance database linked to the National Birth Registry and National Death Registry.
[Results] We identified 2,350,339 singleton pregnancies between 2001 and 2012, of which 7,660 (0.3%) were delivered by mothers with pre-existing epilepsy before pregnancy. Pregnancies in epilepsy patients were associated with an adjusted odds ratio (OR; 95% confidence intervals [CIs]) of 18.79 (15.5-22.7) for puerperal cerebrovascular disorders, 10.95(2.63-45.5) for aneurysm, 3.87 (1.44-10.4) for maternal death within 30 days, and 1.57 (1.28-1.93) for stillbirth. Perinatal outcome was compromised in offspring of mothers with epilepsy, with an OR (95% CIs) of 1.37 (1.27-1.47) for low birth weight, 1.35 (1.26-1.44) for prematurity, 1.33 (1.16-1.53) and 1.43 (1.10-1.87) for a low 1-minute and 5-minute Apgar scores.
[Conclusions] Puerperal cerebrovascular disease and mortality are increased in mothers with epilepsy, whose fetal-neonatal outcomes are compromised.