Risk of Abortions/Stillbirths in Women with Epilepsy: A Prospective, Controlled Study.

Objective: To assess the risk of abortions/stillbirths in women with epilepsy Methods: in a prospective, control study, pregnant women with epilepsy (WWE) and control group of pregnant women, who had neither history of epilepsy nor history of intake of antiepileptic drugs, but matched for age, parity and period of gestation were followed up till delivery to assess the risk of abortions/stillbirths. Women with severe comorbid conditions or women, who opted for medical termination of pregnancy for reasons unrelated to status of fetus were excluded from study. Results: 424 WWE and 387 controls were followed up till delivery. 29 WWE [6.8%] and 9 women in control group [2.3%] had abortion or stillbirth [P value 0.01]. Presence of generalized tonic clonic seizures during first trimester [14.7% vs 6.2% P value 0.05] and polytherapy with antiepileptic drugs [14.5% vs 5.4% P value 0.03] increased the risk of abortions/stillbirths in WWE. Use of antiepileptic drugs as monotherapy did not increase the risk of abortions or stillbirths in WWE. Conclusions: WWE had three times increased risk of abortions or stillbirths as compared to control group. Presence of generalized tonic clonic seizures during first trimester and use of polytherapy increased the risk in WWE, but antiepileptic drug use as monotherapy did not increase the risk of abortion or stillbirth in WWE. [ABSTRACT FROM AUTHOR]