The course and outcome of pregnancy in women with epilepsy—a 6-year prospective study

SummaryNinety-five pregnancies among 88 epileptic women were studied prospectively between 1982 and 1988. There were six miscarriages, three preterm pregnancies and 86 term pregnancies, resulting in 92 babies. There were no stillbirths, one neonatal death and one maternal death. The incidence of breech presentation and mode of delivery amongst epileptic mothers did not differ from that amongst control mothers delivering in the same unit. Birth weight and head circumference of the babies born to epileptic mothers did not differ from those of babies born to control mothers. There was also no difference in head circumference between babies born to epileptic mothers on different anticonvulsant regimens. There were eight minor and one major congenital malformations amongst the 92 babies. The incidence of talipes was 43·5 per 1000 live births, which is significantly greater than the 2·54 per 1000 incidence in the Plymouth Health Authority population. Poor control of epilepsy was not associated with malformations. Epileptic women were found to be of lower social class than the local population. Seventy-three per cent of the epileptic women were managed on a single anticonvulsant drug, which probably explains the good results obtained in this series.