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Abstract
Objective
Although early evidence shows that epilepsy can increase the risks of adverse pregnancy, some outcomes are still debatable. We performed a systematic review and meta-analysis to explore the effects of maternal and fetal adverse outcomes in pregnant women with epilepsy.
Methods
PubMed, Embase, Cochrane, and Web of Science were employed to collect studies that investigated the potential risk of obstetric complications during the antenatal, intrapartum, or postnatal period, as well as any neonatal complications. The search was conducted from inception to November 16, 2022. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of the included original studies. The odds ratio (OR) values were extracted after adjusting for confounders to measure the relationship between pregnant women with epilepsy and adverse maternal or fetal outcomes. The protocol for this systematic review is registered with PROSPERO ID CRD42023391539.
Results
Of 35 articles identified, there were 142,577 mothers with epilepsy and 34,381,373 mothers without epilepsy. Our study revealed a significant association between pregnant women with epilepsy (PWWE) and the incidence of cesarean section, preeclampsia/eclampsia, gestational hypertension, induction of labor, gestational diabetes and postpartum hemorrhage compared with those without epilepsy. Regarding newborns outcomes, PWWE versus those without epilepsy had increased odds of preterm birth, small for gestational age, low birth weight (<2500 g), and congenital malformations, fetal distress. The odds of operative vaginal delivery, newborn mortality, and Apgar (≤ 7) were similar between PWWE and healthy women.
Conclusion
Pregnant women affected by epilepsy encounter a higher risk of adverse obstetric outcomes and fetal complications. Therefore, it is crucial to develop appropriate prevention and intervention strategies prior to or during pregnancy to minimize the negative impacts of epilepsy on maternal and fetal health.
Author contributions
Conceptualization: Huimin Kuang, Lin Zhang; Data curation: Huimin Kuang, Lei Wei; Formal analysis: Huimin Kuang; Funding acquisition:Yuan Wu; Investigation: Yixun Li, Lei Wei; Methodology: Yixun Li, Lin Zhang; Project administration: Yixun Li; Resources: Yixun Li; Software: Yuling Lu, Yuan Wu; Supervision: Yuling Lu, Yuan Wu; Validation: Yuling Lu, Yuan Wu; Visualization: Lin Zhang, Yuan Wu; Writing -original draft: Huimin Kuang, Yixun Li, Yuling Lu, Lin Zhang, Lei Wei, Yuan Wu; Writing-review & editing: Huimin Kuang, Yixun Li, Yuling Lu, Lin Zhang, Lei Wei, Yuan Wu, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Data availability statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.