An analysis on clinical characteristics of 36 epileptics with pregnancy_Journal of Epilepsy

Authors：

XIAO Peichen ^1,2 , WANG Xiaorong ³ ,  BAI Lian ³ , WANG Guangxin ^1,2

1. Cheeloo College of Medicine, Shandong University, Jinan 250012, China;
2. Innovation Center of Intelligent Diagnosis, Jinan Central Hospital, Jinan 250013, China;
3. General Medical Department, Jinan Central Hospital, Jinan 250013, China;

Corresponding author：

BAI Lian, Email: 2280887385@qq.com

Keywords：

Pregnancy; Epilepsy; Antiseizure medications; Clinical characteristics; Pregnancy outcomes

DOI：

10.7507/2096-0247.202201003

Video：

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Objective To investigate the clinical characteristics of epileptics with pregnancy and then provide reference for standardized management of epileptics with pregnancy. Methods From June 2012 to June 2021, epileptics with pregnancy who delivered in Jinan Central Hospital were selected as the research subjects. The clinical data such as the application of Antiseizure medications (ASMs) during pregnancy, seizure frequency, pregnancy outcomes, delivery ways, offspring feeding ways and the incidence of complications were investigated and analyzed. Results Among 36 epileptics with pregnancy, 20 cases (55.56%) were treated with ASMs alone, 5 cases (13.88%) were treated with combined medication, and 11 cases (30.56%) were treated without ASMs during pregnancy. 15 cases (41.67%) adhered to systematic application of ASMs, 17 cases (47.22%) did not adhere to systematic application of ASMs, and 4 cases (11.11%) had unknown medication history. The frequency of seizures increased in 5 cases, decreased in 7 cases and unchanged in 24 cases during pregnancy. Pregnancy outcomes: full-term delivery in 33 cases (91.67%), preterm delivery in 1 case (2.78%) and abortion in 2 cases (5.56%). Delivery mode: cesarean section in 31 cases (91.18%), vaginal delivery in 3 cases (8.82%). After delivery, 4 cases (11.76%) were fed with milk powder and 30 cases (88.24%) were breast-fed. Complications: There were 6 cases complicated with anemia (16.67%), 5 cases complicated with gestational hypertension (13.89%), 3 cases complicated with gestational diabetes (8.33%), 4 cases complicated with premature rupture of membranes (11.11%), 2 cases complicated with fetal growth restriction (5.56%), 2 cases complicated with oligohydramnios (5.56%), 3 cases complicated with fetal distress (8.33%) and 3 cases complicated with neonatal asphyxia (8.33%). Conclusions The proportion of epileptics with pregnancy who were systematically treated with ASMs was low and the seizures were poorly controlled. There is a lack of standardized management for such patients in clinical practice.

Citation： XIAO Peichen, WANG Xiaorong, BAI Lian, WANG Guangxin. An analysis on clinical characteristics of 36 epileptics with pregnancy. Journal of Epilepsy, 2022, 8(3): 213-216. doi: 10.7507/2096-0247.202201003 Copy

1.	Viale L, Allotey J, Cheong-See F, et al. Epilepsy in pregnancy and reproductive outcomes: a systematic review and meta-analysis. Lancet, 2015, 386(10006): 1845-1852.
2.	Fisher RS, Acevedo C, Arzimanoglou A, et al. ILAE official report: a practical clinical definition of epilepsy. Epilepsia, 2014, 55(4): 475-482.
3.	Harden CL, Meador KJ, Pennell PB, et al. Practice parameter update: Management issues for women with epilepsy-focus on pregnancy (an evidence-based review): teratogenesis and perinatal outcomes. Neurology, 2009, 73(2): 133-141.
4.	Soontornpun A, Choovanichvong T, Tongsong T. Pregnancy outcomes among women with epilepsy: A retrospective cohort study. Epilepsy Behav, 2018, 82: 52-56.
5.	Vajda FJE, O Brien TJ, Lander CM, et al. Does pregnancy per se make epilepsy worse? Acta Neurol Scand, 2016, 133: 380-383.
6.	Kusznir VB, Barreto CF, Mella CC. Outcomes of pregnant women with refractory epilepsy. Seizure, 2019, 69: 251-257.
7.	Huang CY, Dai YM, Feng LM, et al. Clinical characteristics and outcomes in pregnant women with epilepsy. Epilepsy Behav, 2020, 112: 107433.
8.	Tomson T, Battino D, Perucca E. Teratogenicity of antiepileptic drugs. Curr Opin Neurol, 2019, 32(2): 246-252.
9.	Jacob S, Nair AB. An updated overview on therapeutic drug monitoring of recent antiepileptic drugs. Drugs R D, 2016, 16(4): 303-316.
10.	单浩杰, 郑东琳, 杨帆, 等. 抗癫痫药物在妊娠期癫痫患者中的应用分析. 中国医刊, 2018, 53(10): 1131-1135.
11.	Richards N, Reith D, Stitely M, et al. Antiepileptic drug exposure in pregnancy and pregnancy outcome from national drug usage data. BMC Pregnancy Childbirth, 2018, 18(1): 84.
12.	Hanaya R, Arita K. The new antiepileptic drugs: their neuropharmacology and clinical indications. Neurol Med Chir (Tokyo), 2016, 56(5): 205-20.
13.	Chen ZB, Brodie MJ, Kwan P. What has been the impact of new drug treatments on epilepsy? Curr Opin Neurol, 2020, 33 (2) : 185-190.
14.	Patsalos PN, Spencer EP, Berry DJ. Therapeutic drug monitoring of antiepileptic drugs in epilepsy: a 2018 update. Ther Drug Monit, 2018, 40(5): 526-548.
15.	Meador KJ, Baker GA, Browning N, et al. Fetal antiepileptic drug exposure and cognitive outcomes at age 6 years (NEAD study): a prospective observational study. Lancet Neurol, 2013, 12(3): 244-252.
16.	Razaz N, Tomson T, Wikström AK, et al. Association between pregnancy and perinatal outcomes among women with epilepsy. JAMA Neurol, 2017, 74(8): 983-991.
17.	Menzler K, Fuest S, Immisch I, et al. Epilepsy and Pregnancy. Nervenarzt, 2016, 87(9): 937-942.
18.	Birnbaum AK, Meador KJ, Karanam A, et al. Antiepileptic drug exposure in infants of breastfeeding mothers with epilepsy. JAMA Neurol, 2020, 77(4): 441-450.
19.	陈兆耀, 姜亚军. 癫痫和抗癫痫药物使用对胎儿的影响. 中华神经医学杂志, 2014, 13(2): 214-216.
20.	Veiby G, Bjørk M, Engelsen BA, et al. Epilepsy and recommendations for breastfeeding. Seizure, 2015, 28: 57-65.

1. Viale L, Allotey J, Cheong-See F, et al. Epilepsy in pregnancy and reproductive outcomes: a systematic review and meta-analysis. Lancet, 2015, 386(10006): 1845-1852.
2. Fisher RS, Acevedo C, Arzimanoglou A, et al. ILAE official report: a practical clinical definition of epilepsy. Epilepsia, 2014, 55(4): 475-482.
3. Harden CL, Meador KJ, Pennell PB, et al. Practice parameter update: Management issues for women with epilepsy-focus on pregnancy (an evidence-based review): teratogenesis and perinatal outcomes. Neurology, 2009, 73(2): 133-141.
4. Soontornpun A, Choovanichvong T, Tongsong T. Pregnancy outcomes among women with epilepsy: A retrospective cohort study. Epilepsy Behav, 2018, 82: 52-56.
5. Vajda FJE, O Brien TJ, Lander CM, et al. Does pregnancy per se make epilepsy worse? Acta Neurol Scand, 2016, 133: 380-383.
6. Kusznir VB, Barreto CF, Mella CC. Outcomes of pregnant women with refractory epilepsy. Seizure, 2019, 69: 251-257.
7. Huang CY, Dai YM, Feng LM, et al. Clinical characteristics and outcomes in pregnant women with epilepsy. Epilepsy Behav, 2020, 112: 107433.
8. Tomson T, Battino D, Perucca E. Teratogenicity of antiepileptic drugs. Curr Opin Neurol, 2019, 32(2): 246-252.
9. Jacob S, Nair AB. An updated overview on therapeutic drug monitoring of recent antiepileptic drugs. Drugs R D, 2016, 16(4): 303-316.
10. 单浩杰, 郑东琳, 杨帆, 等. 抗癫痫药物在妊娠期癫痫患者中的应用分析. 中国医刊, 2018, 53(10): 1131-1135.
11. Richards N, Reith D, Stitely M, et al. Antiepileptic drug exposure in pregnancy and pregnancy outcome from national drug usage data. BMC Pregnancy Childbirth, 2018, 18(1): 84.
12. Hanaya R, Arita K. The new antiepileptic drugs: their neuropharmacology and clinical indications. Neurol Med Chir (Tokyo), 2016, 56(5): 205-20.
13. Chen ZB, Brodie MJ, Kwan P. What has been the impact of new drug treatments on epilepsy? Curr Opin Neurol, 2020, 33 (2) : 185-190.
14. Patsalos PN, Spencer EP, Berry DJ. Therapeutic drug monitoring of antiepileptic drugs in epilepsy: a 2018 update. Ther Drug Monit, 2018, 40(5): 526-548.
15. Meador KJ, Baker GA, Browning N, et al. Fetal antiepileptic drug exposure and cognitive outcomes at age 6 years (NEAD study): a prospective observational study. Lancet Neurol, 2013, 12(3): 244-252.
16. Razaz N, Tomson T, Wikström AK, et al. Association between pregnancy and perinatal outcomes among women with epilepsy. JAMA Neurol, 2017, 74(8): 983-991.
17. Menzler K, Fuest S, Immisch I, et al. Epilepsy and Pregnancy. Nervenarzt, 2016, 87(9): 937-942.
18. Birnbaum AK, Meador KJ, Karanam A, et al. Antiepileptic drug exposure in infants of breastfeeding mothers with epilepsy. JAMA Neurol, 2020, 77(4): 441-450.
19. 陈兆耀, 姜亚军. 癫痫和抗癫痫药物使用对胎儿的影响. 中华神经医学杂志, 2014, 13(2): 214-216.
20. Veiby G, Bjørk M, Engelsen BA, et al. Epilepsy and recommendations for breastfeeding. Seizure, 2015, 28: 57-65.

Journal of Epilepsy

An analysis on clinical characteristics of 36 epileptics with pregnancy

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