Original scientific paper

https://doi.org/10.20471/acc.2020.59.04.04

The Impact of Antiepileptic Treatment in Pregnancy on Perinatal Outcome in Croatia – a Single-Center Study

Vesna Elveđi Gašparović ; Department of Obstetrics and Gynecology, Zagreb University Hospital Centre, Zagreb, Croatia
Mislav Mikuš ; Department of Obstetrics and Gynecology, Zagreb University Hospital Centre, Zagreb, Croatia
Petrana Beljan ; Department of Obstetrics and Gynecology, Zagreb University Hospital Centre, Zagreb, Croatia
Marta Živković ; School of Medicine, University of Zagreb, Zagreb, Croatia
Klara Živković ; School of Medicine, University of Zagreb, Zagreb, Croatia
Luka Matak ; Department of Obstetrics and Gynecology, Zadar General Hospital, Zadar, Croatia

Abstract

Pregnancy can alter the natural course of epilepsy and affect pharmacokinetic
profile of antiepileptic drugs (AEDs) making therapeutic management more demanding. Since there
is no relevant population-based study in Croatia to date, we conducted this research with the aim to
observe antiepileptic treatment policy in pregnancy and to determine if the number of AEDs affects
pregnancy outcomes. The study included all women with epilepsy with singleton pregnancy exposed
to one or more AEDs divided into two groups (group 1: one AED and group 2: more than one AED
used). Data were collected retrospectively at the Department of Obstetrics and Gynecology, Zagreb
University Hospital Centre, Zagreb, Croatia, and included 153 women from January 2010 to December
2018. Primary outcomes included rates of preterm delivery, major fetal malformations, gestational
hypertension, cesarean section rate, and appearance of seizures during pregnancy. We found higher
rates of all pregnancy complications examined than in the general population, while comparison of the
two study groups yielded significant differences. Preterm labor was detected in 30% of deliveries in
polytherapy group compared to 16.6% in monotherapy group (p=0.03). Gestational hypertension was
recorded in 20% of women in polytherapy group vs. 4.90% in monotherapy group (p=0.009). There
was also a high rate of cesarean deliveries in polytherapy group (27.5%). Seizures during pregnancy
occurred in 48.4% of patients in polytherapy group, which was significantly higher than the rate recorded
in monotherapy group (p=0.015). In this single-center retrospective study, women with epilepsy
using AEDs during pregnancy had a higher rate of gestational hypertension and preterm delivery
than the general population of pregnant women. To the best of our knowledge, this is the first
study in Croatia observing antiepileptic treatment policy in pregnancy with regards to AED regimen
and perinatal outcome.

Keywords

Pregnancy; Epilepsy; Antiepileptic drugs; Gestational hypertension; Preterm delivery

Hrčak ID:

253719

URI

https://hrcak.srce.hr/253719

Publication date:

1.12.2020.

Article data in other languages: croatian

Visits: 1.968 *