First and second trimester laboratory changes and perinatal outcomes in pregnant women with epilepsy

Year 2024, Volume: 7 Issue: 5, 549 - 554, 27.09.2024

Zeynep Şeyhanlı , Can Ozan Ulusoy , Gülşan Karabay , Ezgi Koçyıldız , Gizem Aktemur , Betül Tokgöz Çakır , Nazan Vanlı Tonyalı , Samet Kutluay Ergörün , Şevki Çelen , Ali Turhan Çağlar

https://doi.org/10.32322/jhsm.1521532

Abstract

Aims: The aim of this study is to comprehensively evaluate the demographic, first-second trimester laboratory parameters and perinatal outcomes in pregnant women with epilepsy.
Methods: The study had a total of 73 pregnant women with epilepsy, along with 149 healthy pregnant women. Demographic data, first-second trimester laboratory parameters, seizures during pregnancy, the administration of antiepileptic medicines and perinatal outcomes were documented from September 2022 to 2023. Pregnant women with epilepsy were formed into subgroups according to whether they had seizures during pregnancy or not and whether they used antiepileptic drugs, and first- and second-trimester laboratory parameters were compared between the groups. Furthermore, univariate and multivariate linear regression analysis investigated the relationship between these parameters with the composite adverse neonatal outcomes (CANO).
Results: In the study, 72.7% of pregnant women diagnosed with epilepsy were receiving antiepileptic treatment (75.4% monotherapy and 24.6% polytherapy). The incidence of seizures during pregnancy was 38.3%. The epilepsy group exhibited statistically significant differences from the control group in the following areas: gestational age at delivery, preterm birth rate, cesarean section rate, birth weight, neonatal head circumference, APGAR score <7 at the 1st and 5th minutes, and CANO. The Neutrophil to Lymphocyte Ratio (NLR) was significantly higher in the epilepsy group in the second trimester (p=0.027), and the monocyte to lymphocyte ratio (MLR) was significantly higher in the first trimester in the epilepsy group (p<0.001). Upon comparing who experienced seizures during pregnancy and those who did not, no significant difference was found between the two groups. In the univariate logistic regression model, it was determined that having a seizure during pregnancy was a significant predictor, indicating a higher likelihood of developing perinatal complications. Multivariate linear regression analysis showed no significant correlation.
Conclusion: The laboratory results of pregnant women with epilepsy during the first and second trimesters show differences compared to healthy pregnant women. Pregnant women diagnosed with epilepsy were associated with a higher risk of preterm delivery and giving birth to newborns with lower birth weight and head circumference. These differences may have significance in the follow-up and care of pregnant women with epilepsy.

Keywords

Epilepsy, perinatal outcomes, first- and second-trimester laboratory parameters

Ethical Statement

ETHICAL DECLARATIONS Ethics Committee Approval: The study was initiated with the approval of the Ankara Etlik City Hospital Ethics Committee (Date: 2023, Decision No: AESH-EK1-2023-170). Informed Consent: Because the study was designed retrospectively, no written informed consent form was obtained from patients. Referee Evaluation Process: Externally peer-reviewed. Conflict of Interest Statement: The authors have no conflicts of interest to declare. Financial Disclosure: The authors declared that this study has received no financial support. Author Contributions: All of the authors declare that they have all participated in the design, execution, and analysis of the paper, and that they have approved the final version.

Supporting Institution

None

Thanks

The authors extend their sincere admiration and appreciation to Prof. Dr. Can Tekin Iskender, whose profound expertise and experience significantly advanced our scientific progress and passed away so early.

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