Top

Archives of Gynecology and Obstetrics

Published in:

01-09-2017 | Review

Effect of epilepsy in pregnancy on fetal growth restriction: a systematic review and meta-analysis

Authors: Daijuan Chen, Lisha Hou, Xia Duan, Hongling Peng, Bing Peng

Published in: Archives of Gynecology and Obstetrics | Issue 3/2017

Abstract

Purpose

Epilepsy is one of the most common neurological diseases during pregnancy. However, the influence of epilepsy on fetal growth is not understood. Thus, this study conducted a meta-analysis to determine the influence of epilepsy during pregnancy on fetal growth restriction (FGR).

Methods

BIOSIS, Medline, Embase, and PubMed databases were searched between January 2000 and January 2016. Without imposing language or regional restrictions, referenced articles were selected.

Results

Final analysis included 684 citations from 11 studies. Estimated risk of FGR was 1.28-fold higher in epileptic pregnant women than in non-epileptic women [95% confidence interval (95% CI) 1.09–1.50, p < 0.05]. Given the course of previous studies, hierarchical analysis of pregnant women who use antiepileptic drugs (AEDs) was conducted. Results show that FGR rate is significantly increased even if AEDs were taken [odds ratio 1.26, 95% CI 1.13–1.41, p < 0.05].

Conclusions

Although modest bias cannot be avoided, our meta-analysis indicated that epilepsy participates in fetal development as an unfavorable factor, and AEDs seemed to be useless in decreasing the occurrence rate of FGR.

Fisher RS, Acevedo C, Arzimanoglou A, Bogacz A, Cross JH, Elger CE, Engel J Jr, Forsgren L, French JA, Glynn M, Hesdorffer DC, Lee BI, Mathern GW, Moshe SL, Perucca E, Scheffer IE, Tomson T, Watanabe M, Wiebe S (2014) ILAE official report: a practical clinical definition of epilepsy. Epilepsia 55(4):475–482. doi:10.1111/epi.12550 CrossRefPubMed

Scheffer IE, Berkovic S, Capovilla G, Connolly MB, French J, Guilhoto L, Hirsch E, Jain S, Mathern GW, Moshe SL, Nordli DR, Perucca E, Tomson T, Wiebe S, Zhang YH, Zuberi SM (2017) ILAE classification of the epilepsies: position paper of the ILAE Commission for Classification and Terminology. Epilepsia 58(4):512–521. doi:10.1111/epi.13709 CrossRefPubMed

Barroso FVL, Araujo Júnior E, Guazelli CAF, Santana EFM, Rolo LC, Martins MdG, Moron AF (2015) Perinatal outcomes from the use of antiepileptic drugs during pregnancy: a case–control study. J Matern-Fetal Neonatal Med 28(12):1445–1450. doi:10.3109/14767058.2014.955006 CrossRefPubMed

Najafi MR, Sonbolestan F, Sonbolestan SA, Zare M, Mehvari J, Meshkati SN (2012) The course and outcome of pregnancy and neonatal situation in epileptic women. Adv Biomed Res 1:4. doi:10.4103/2277-9175.94426 CrossRefPubMedPubMedCentral

Brosh K, Matok I, Sheiner E, Koren G, Wiznitzer A, Gorodischer R, Levy A (2011) Teratogenic determinants of first-trimester exposure to antiepileptic medications. J Popul Ther Clin Pharmacol 18:e89–e98PubMed

Borthen I, Eide MG, Veiby G, Daltveit AK, Gilhus NE (2009) Complications during pregnancy in women with epilepsy: population-based cohort study. BJOG: Int J Obstet Gynaecol 116(13):1736–1742. doi:10.1111/j.1471-0528.2009.02354.x CrossRef

Hauser WA, Annegers JF, Kurland LT (1993) Incidence of epilepsy and unprovoked seizures in Rochester, Minnesota: 1935–1984. Epilepsia 34(3):453CrossRefPubMed

Edey S, Moran N, Nashef L (2014) SUDEP and epilepsy-related mortality in pregnancy. Epilepsia 55(7):e72–e74. doi:10.1111/epi.12621 CrossRefPubMed

Veiby G, Daltveit AK, Engelsen BA, Gilhus NE (2009) Pregnancy, delivery, and outcome for the child in maternal epilepsy. Epilepsia 50(9):2130–2139CrossRefPubMed

10.

Lin HL, Chen YH, Lin HC, Lin HC (2009) No increase in adverse pregnancy outcomes for women receiving antiepileptic drugs. J Neurol 256(10):1742–1749. doi:10.1007/s00415-009-5222-3 CrossRefPubMed

11.

Nardozza LM, Caetano AC, Zamarian AC, Mazzola JB, Silva CP, Marcal VM, Lobo TF, Peixoto AB, Araujo Junior E (2017) Fetal growth restriction: current knowledge. Arch Gynecol Obstet 295(5):1061–1077. doi:10.1007/s00404-017-4341-9 CrossRefPubMed

12.

Stanley JL, Andersson IJ, Hirt CJ, Moore L, Dilworth MR, Chade AR, Sibley CP, Davidge ST, Baker PN (2012) Effect of the anti-oxidant tempol on fetal growth in a mouse model of fetal growth restriction. Biol Reprod 87(1):25, 21–28. doi:10.1095/biolreprod.111.096198

13.

Hvas CL, Henriksen TB, Ostergaard JR, Dam M (2005) Epilepsy and pregnancy: effect of antiepileptic drugs and lifestyle on birthweight. BJOG: Int J Obstet Gynaecol 107(7):896–902CrossRef

14.

Wells G, Shea B, O’Connell D (2000) Proceedings of the third symposium on systematic reviews beyond the basics. SBOD. Improving quality and impact; The Newcastle–Ottawa Scale (NOS) for assessing the quality of non-randomised studies in meta-analysis, Oxford, 3–5 July

15.

Kilic D, Pedersen H, Kjaersgaard MI, Parner ET, Vestergaard M, Sorensen MJ, Olsen J, Bech BH, Christensen J, Pedersen LH (2014) Birth outcomes after prenatal exposure to antiepileptic drugs—a population-based study. Epilepsia 55(11):1714–1721. doi:10.1111/epi.12758 CrossRefPubMed

16.

Farmen AH, Grundt J, Tomson T, Nakken KO, Nakling J, Mowinchel P, Lossius M (2015) Intrauterine growth retardation in foetuses of women with epilepsy. Seizure 28:76–80. doi:10.1016/j.seizure.2015.02.026 CrossRefPubMed

17.

Katz O, Levy A, Wiznitzer A, Sheiner E (2006) Pregnancy and perinatal outcome in epileptic women: a population-based study. J Matern-Fetal Neonatal Med 19(1):21–25. doi:10.1080/14767050500434096 CrossRefPubMed

18.

McPherson JA, Harper LM, Odibo AO, Roehl KA, Cahill AG (2013) Maternal seizure disorder and risk of adverse pregnancy outcomes. Am J Obstet Gynecol 208(5):378 e371–378 e375. doi:10.1016/j.ajog.2013.01.048 CrossRef

19.

Jadhav SV, Jadhav VK (2013) Comparative study of obstetric outcome in epileptic and non-epileptic pregnant women. Indian Med Gaz 147(9):352–357

20.

Venturella A, Harper L, Odibo A, Roehl K, Cahill A (2012) 320: maternal seizure disorder is not associated with adverse pregnancy outcomes. Am J Obstet Gynecol 206(1):S152CrossRef

21.

Viinikainen K, Heinonen S, Kai E, Kälviäinen R (2006) Community-based, prospective, controlled study of obstetric and neonatal outcome of 179 pregnancies in women with epilepsy. Epilepsia 47(1):186–192CrossRefPubMed

22.

Chen YH, Chiou HY, Lin HC, Lin HL (2009) Affect of seizures during gestation on pregnancy outcomes in women with epilepsy. Arch Neurol 66(8):979–984CrossRefPubMed

23.

Veiby G, Daltveit AK, Engelsen BA, Gilhus NE (2014) Fetal growth restriction and birth defects with newer and older antiepileptic drugs during pregnancy. J Neurol 261(3):579–588CrossRefPubMed

24.

Viale L, Allotey J, Cheong-See F, Arroyo-Manzano D, McCorry D, Bagary M, Mignini L, Khan KS, Zamora J, Thangaratinam S (2015) Epilepsy in pregnancy and reproductive outcomes: a systematic review and meta-analysis. Lancet 386(10006):1845–1852. doi:10.1016/s0140-6736(15)00045-8 CrossRefPubMed

25.

Crawford P (1997) Epilepsy and pregnancy: good management reduces the risks. Prof Care Mother Child 7(1):17–18PubMed

26.

Lainé-Cessac P, Le JS, Rosenau L, Gamelin L, Allain P, Grosieux P (1995) Uncontrolled retrospective study of 75 pregnancies in women treated for epilepsy. Journal De Gynécologie Obstétrique Et Biologie De La Reproduction 24(5):537

27.

Perucca E (2005) Birth defects after prenatal exposure to antiepileptic drugs. Lancet Neurol 4(11):781–786CrossRefPubMed

28.

Tomson T, Ohman I, Vitols S (1997) Lamotrigine in pregnancy and lactation: a case report. Epilepsia 38(9):1039–1041CrossRefPubMed

29.

Ohman I, Vitols S, Tomson T (2000) Lamotrigine in pregnancy: pharmacokinetics during delivery, in the neonate, and during lactation. Epilepsia 41(6):709–713CrossRefPubMed

30.

Rambeck B, Kurlemann G, Stodieck SR, May TW, Jürgens U (1997) Concentrations of lamotrigine in a mother on lamotrigine treatment and her newborn child. Eur J Clin Pharmacol 51(6):481CrossRefPubMed

31.

Bülau P, Paar WD, Unruh GEV (1988) Pharmacokinetics of oxcarbazepine and 10-hydroxy-carbazepine in the newborn child of an oxcarbazepine-treated mother. Eur J Clin Pharmacol 34(3):311–313CrossRefPubMed

32.

Ishizaki T, Yokochi K, Chiba K, Tabuchi T, Wagatsuma T (1981) Placental transfer of anticonvulsants (phenobarbital, phenytoin, valproic acid) and the elimination from neonates. Pediatr Pharmacol 1(4):291–303

33.

Nau H, Rating D, Koch S, Häuser I, Helge H (1981) Valproic acid and its metabolites: placental transfer, neonatal pharmacokinetics, transfer via mother’s milk and clinical status in neonates of epileptic mothers. J Pharmacol Exp Ther 219(3):768PubMed

34.

Pacifici GM, Nottoli R (1995) Placental transfer of drugs administered to the mother. Clin Pharmacokinet 28(3):235–269CrossRefPubMed

35.

Arvela P (1995) Carbamazepine and its metabolites in human perfused placenta and in maternal and cord blood. Epilepsia 36(3):241–248CrossRefPubMed

36.

Myllynen P, Pienimäki P, Jouppila P, Vähäkangas K (2001) Transplacental passage of oxcarbazepine and its metabolites in vivo. Epilepsia 42(11):1482CrossRefPubMed

37.

Pienimäki P, Lampela E, Hakkola J, Arvela P, Raunio H, Vähäkangas K (1997) Pharmacokinetics of oxcarbazepine and carbamazepine in human placenta. Epilepsia 38(3):309–316CrossRefPubMed

38.

Bech BH, Kjaersgaard MIS, Pedersen HS, Howards PP, Sørensen MJ, Olsen J, Parner ET, Pedersen LH, Vestergaard M, Christensen J (2014) Use of antiepileptic drugs during pregnancy and risk of spontaneous abortion and stillbirth: population based cohort study. BMJ Clin Res 349:g5159

39.

Simon R, Altman DG (1994) Statistical aspects of prognostic factor studies in oncology. Br J Cancer 69(6):979–985CrossRefPubMedPubMedCentral

Title: Effect of epilepsy in pregnancy on fetal growth restriction: a systematic review and meta-analysis
Authors: Daijuan Chen
Lisha Hou
Xia Duan
Hongling Peng
Bing Peng
Publication date: 01-09-2017
Publisher: Springer Berlin Heidelberg
Published in: Archives of Gynecology and Obstetrics / Issue 3/2017
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-017-4404-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Effect of epilepsy in pregnancy on fetal growth restriction: a systematic review and meta-analysis

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 3/2017

What can we do to reduce the associated costs in induction of labour of intrauterine growth restriction foetuses at term? A cost-analysis study

Comparison of maternal and fetal complications in elective and emergency cesarean section: a systematic review and meta-analysis

Anti-Mullerian hormone (AMH) and embryo quality assessed by time-lapse imaging (TLI): a cross-sectional observational study

Effect of routine rapid insertion of Bakri balloon tamponade on reducing hemorrhage from placenta previa during and after cesarean section

Down-regulation of PARP1 by miR-891b sensitizes human breast cancer cells to alkylating chemotherapeutic drugs

Subserosal uterine injection of blue dye for the identification of the sentinel node in patients with endometrial cancer: a feasibility study