No increase in adverse pregnancy outcomes for women receiving antiepileptic drugs

Abstract The objectives of this study were (1) to investigate
the incidence of adverse pregnancy outcomes among
the epileptic and general populations, including small for
gestational age (SGA), low birth weight (LBW) and preterm
delivery, using two large-scale nationwide population-
based databases, and (2) to compare the risk of these
adverse pregnancy outcomes between epileptic women
who did and who did not receive antiepileptic drug (AED)
treatment during pregnancy. This study used two national
datasets: the National Health Insurance Research Dataset
and birth certificate registry. We identified a total of 1,182
women who gave birth from 2001 to 2003 in Taiwan who
had been diagnosed with epilepsy within the 2 years preceding
the index delivery, together with 5,910 matched
women as a comparison cohort. Multivariate logistic
regression analyses were performed for estimation of risk.
We found that approximately 14% of women with epilepsy received AED treatment during gestation. The adjusted
odds of LBW, preterm births and SGA for epileptic women
not receiving AED treatment during pregnancy were 1.31
(95% CI, 1.02–1.68), 1.35 (95% CI, 1.07–1.71) and 1.23
(95% CI, 1.03–1.46) times that of women without epilepsy,
respectively. In contrast, no significant difference in the
risk of LBW infants, preterm births and SGA babies was
observed between epileptic mothers receiving AED treatment
during pregnancy and women without epilepsy. Our
study documents an increased risk of adverse pregnancy
outcomes for epileptic women who do not receive AED
treatment during pregnancy, but none for epileptic women
who do receive treatment.