FACTORS INFLUENCING THE RISK OF ABNORMAL PREGNANCY OUTCOME IN EPILEPTIC WOMEN - A MULTICENTER PROSPECTIVE-STUDY

We studied pregnancy outcome in preconceptionally recruited epileptic and control women in a multi-centre prospective non-intervention study at two university hospitals and three general hospitals. We evaluated 225 singleton pregnancies: 119 pregnancies of epileptic women who rec eived either antiepileptic drugs (AEDs) (n=99) or not (n=20), and 106 pregnancies of controls. The main outcome measures were abnormal pregn ancy outcome: major and minor congenital malformations, ectopic pregna ncies, abortions; neonatal headcircumference; birth weight and birth l ength. Epileptic women had a two-fold risk of having an abnormal pregn ancy outcome or an infant with minor malformations compared to healthy controls (odds ratio, with 95% confidence interval, respectively 2.1 (1.1, 4.0) and 2.0 (1.0, 4.0)). A significant correlation between the prevalence of abnormal pregnancy outcome and duration of epilepsy and AED treatment was found (risk increased by 9% (6%, 16%) per annum). No significant effect in terms of the type, the number or the serum leve l of the AEDs could be established. The head circumference of infants of epileptic mothers was significantly smaller (0.7 (1.2, 0.28 cm) com pared to controls. An effect on the outcome of pregnancy of maternal f olate supplementation or of folate blood concentrations during the per iconceptional period and first trimester of pregnancy could not be det ermined. The severity of maternal epilepsy and/or AED treatment influe nces pregnancy outcome.