Pregnancy outcomes among women with epilepsy in Washington State, 1987-2012

Epilepsy, one of the most common neurological disorders, is characterized by chronic recurrent seizures and may be associated with pregnancy complications and adverse outcomes for the mother and infant. We compared the occurrence of selected adverse pregnancy outcomes among women with epilepsy to occurrence among women without epilepsy with deliveries in Washington State, 1987-2012. We conducted a population-based retrospective cohort study using linked vital-hospital discharge records to identify women with epilepsy based on diagnosis codes in the hospital discharge record at delivery. For comparison, a random sample of women without these codes with deliveries during the same years was identified. Adverse maternal and infant outcomes, and rehospitalization and mortality within 2 years of delivery were considered. Relative risks (RRs) and 95% confidence intervals (CI) were calculated using Poisson regression. Women with epilepsy had greater risk of several adverse pregnancy outcomes, including preeclampsia (RR: 1.2; 95% CI: 1.06-1.51) and gestational diabetes (RR: 1.27; 95% CI: 1.08-1.50), and were more likely to require intensive care unit admission after delivery (RR: 7.41; 95% CI: 3.15-17.46). They were more likely to be rehospitalized (RR: 1.32; 95% CI: 1.19-1.45), or to die (RR: 6.15; 95% CI: 2.02-18.73) during the 2 years after delivery, compared to women without epilepsy. Their infants had increased risks of malformation (RR: 1.25; 95% CI: 1.07-1.47) and of being small for gestational age (RR: 1.35; 95% CI 1.20-1.53), but were not at risk for early or late mortality. These findings may be used to inform clinicians caring for women with epilepsy.