Epilepsy and Pregnancy: A Report from the Oxford Record Linkage Study

TLDR

The Oxford Record Linkage Study identified 223 infants born to 168 epileptic mothers, and each livebirth was matched to three controls on social class, civil status, maternal age, parity, hospital, and delivery year to evaluate congenital abnormalities. The study found a highly significant excess of congenital abnormalities among infants of epileptic mothers (13.8 % versus 5.6 % in matched controls), six stillbirths (two grossly malformed), and no association between seizure frequency or epilepsy duration and defect frequency, except for two early‑onset cases.

Abstract

The files of the Oxford Record Linkage Study were used to identify 223 infants delivered to 168 epileptic women as the result of 218 pregnancies. There were six stillbirths, two of which were grossly malformed. It was shown that the population of epileptic mothers differed significantly from the total reproducing population in respect of social class. Each pregnancy resulting in a livebirth was therefore matched exactly for social class, civil status, maternal age, parity, hospital, and year of delivery with three control deliveries resulting in livebirths. The defects noted at birth were abstracted from the Record Linkage files, and any subsequent hospital admissions or deaths of the children were also abstracted.There were highly significant excesses of congenital abnormalities among the infants born to epileptic mothers (13.8% of livebirths had some degree of defect of congenital origin compared with 5.6% of controls, P <0.0005). It was shown that neither the frequency with which the mother had fits nor the length of time she had had the epilepsy seemed to bear any relation to the frequency of defects in the offspring-with the exception of the two mothers who developed epilepsy in the first