Maternal Mortality 8 Times Higher With Epilepsy Than Without

Jakob Christensen, MD, PhD

Maternal mortality for women with epilepsy is considerably higher than for women without the condition, according to new data.

Led by Jakob Christensen, MD, PhD, a neurologist in the Department of Clinical Medicine at Aarhus University in Denmark, the study examined the rates of maternal mortality, defined as the mortality in pregnancy and the first 42 days after termination of pregnancy.

The data were analyzed with a conditional logistic model with its exposure as diagnosis of epilepsy within 5 years before pregnancy termination. “For comparison, we estimated the mortality in women with epilepsy with those diagnosed with epilepsy within 5 years regardless of pregnancy status,” Christensen and colleagues noted.

The study included data from more than 2 million pregnancies in Denmark, from women who were born from January 1, 1964, to December 31, 1994. Of those, 11,976 (0.57%) pregnancies involved women who had received a diagnosis of epilepsy.

In total, there were 176 maternal deaths, 5 of which were of women who had a diagnosis of epilepsy. The rate of mortality associated with an epilepsy diagnosis was more than 5 times higher than it was for those without a diagnosis (OR, 5.57; 95% CI, 2.23-13.9; P<.001).

More alarming, women with epilepsy of childbearing age, defined as 18 to 50 years, had a mortality rate that was more than 8 times higher than for those without epilepsy, regardless of pregnancy.

Maternal mortality rate for women with epilepsy in the study population was lower than rates that had been reported in the United States and the United Kingdom. “However, the maternal mortality and especially the mortality in all women with epilepsy of childbearing age were considerably higher compared [with] women without epilepsy, suggesting a need for improved care in women with epilepsy,” the authors wrote.

According to data from Epilepsy Action, the Epilepsy Society of Britain, there were 14 deaths of pregnant women with epilepsy in the United Kingdom from 2006 to 2008. Eleven of those deaths were determined to be cases of sudden unexpected death in epilepsy and another from status epilepticus. The maternal mortality rate in the United Kingdom is 11.39 per 100,000 births, while the rate in the United States is reportedly 12.7 per 100,000 births, according to the US Office of Disease Prevention and Health Promotion.

Even more extensive coverage pertaining to epilepsy can be found on MD Magazine's new sister site, NeurologyLive.