Obstetric and neonatal outcomes: Antiseizure medication profile and seizure types in pregnant women in a vulnerability state, Brazil

Abstract

Abstract Objectives To describe obstetric and neonatal outcomes, antiseizure medication (ASM) use, and types of seizures in pregnant women with epilepsy (PWWE). Methods This retrospective cohort study used data collected from the medical records of high-risk maternity hospitals in Alagoas. PWWE aged < 40 years, with controlled or refractory seizures and pregnant women without epilepsy (control group) between 2008 and 2021 were included in the study. Results The obstetric and neonatal outcomes observed in PWWE were pregnancy-related hypertension (PrH), vaginal bleeding, preeclampsia, oligohydramnyos, polyhydramnios, stillbirth, greater likelihood of PrH in those with generalized tonic-clonic seizures (GTCS), maternal ICU admission in those with GTCS and status epilepticus and phenytoin and lamotrigine use. PWWE with GTCS had a higher risk of stillbirth. and premature delivery. PWWE with status epilepticus were treated with lamotrigine. Phenobarbital(PB) with diazepam was commonly used in GTCS and status epilepticus. 14% of the patients did not use antiseizure medication (ASM), 50.2% used monotherapy, and 35.8% used polytherapy. 60.9% of patients used PB and 25.2% used carbamazepine. Conclusion This study describes the association between adverse obstetric and neonatal outcomes and severe seizure types in PWWE.