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Poster session II Diabetes, labor, medical-surgical-disease, obstetric quality & safety, prematurity, ultrasound-imaging: Abstracts 237 – 386| Volume 206, ISSUE 1, SUPPLEMENT , S152, January 01, 2012

320: Maternal seizure disorder is not associated with adverse pregnancy outcomes

      Objective

      Prior studies are conflicting regarding whether a maternal seizure disorder is associated with adverse pregnancy outcomes, such as intrauterine growth restriction (IUGR) or intrauterine fetal demise (IUFD). Many positive studies are based on birth certificate data, which may be flawed and prone to misclassification. We sought to estimate the association between maternal seizure disorder and IUGR.

      Study Design

      A retrospective cohort study of all consecutive singleton pregnancies undergoing routine anatomic survey between 15 and 22 weeks at a tertiary medical center. Pregnancy outcomes in women with a self reported history of seizure disorder were compared with women who reported no medical problems. Pregnancies complicated by other co-morbidities, including diabetes and hypertension, and fetal anomalies were excluded. Importantly, dedicated research nurses identified outcomes in a prospective manner. The primary outcome was IUGR at >24 weeks gestation, defined as a birth weight <10th percentile for gestational age based on the Alexander growth standard. Secondary outcomes included IUFD, preeclampsia, and preterm delivery <37 weeks. Univariate and multivariate analyses were performed.

      Results

      Of 63,561 subjects, 47,495 were included in the analysis, of which 445 had a seizure disorder. After controlling for smoking and black race, women with a seizure disorder had a similar risk of having a baby with IUGR compared to women without a seizure disorder (10% vs 8%, adjusted odds ratio (AOR) 1.2, 95% confidence interval [CI] 0.94-1.65). The risk of IUFD was similar in both groups (0.7% vs 0.7%, RR 1.0, 95% CI 0.32-3.07) as was the risk of preeclampsia (7.6% vs 6.9%, AOR 1.1, 95% CI 0.79-1.53). In subanalysis of only women reporting use of antiepileptic medication, the risks for IUGR and IUFD remained similar to the no seizure disorder group.

      Conclusion

      Our data suggest no increased risk of IUGR or IUFD for pregnancies complicated by maternal seizure disorder. In the absence of other risk factors, serial ultrasounds and antenatal testing may not be indicated in this population of patients.
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