Abstracts

Rationale: Very high mortality has been reported among women with epilepsy during pregnancy and the perinatal period in the UK and the United States. We studied the maternal mortality in women with epilepsy in a national cohort study in Denmark  Methods: This was a matched case control study of  all pregnant women in Denmark. The main outcome was maternal mortality defined as the mortality in pregnancy and the first 42 days after termination of pregnancy in Denmark.. We included women born in Denmark between January 1st, 1962 and December 31st 1994, who were alive on their 18th birthday. Data was analyzed using a conditional logistic model with the diagnosis of epilepsy within five years before the termination of pregnancy as the exposure. For comparison, we estimated the mortality in women with epilepsy diagnosed with epilepsy within five years regardless of pregnancy status.   Results: We identified 2,105,084 pregnancies including 11,976 (0.57%) pregnancies were the mother was diagnosed with epilepsy. Of the 176 maternal deaths in this cohort, five had a diagnosis of epilepsy. The mortality associated with an epilepsy diagnosis was more than five times higher compared to the mortality in women without this diagnosis (OR = 5.57 (95% CI: 2.23-13.9, p < 0.001)). The mortality in women of childbearing age (aged 18-50) regardless of pregnancy was more than eight times higher in women with epilepsy when compared to women without epilepsy. Conclusions: Maternal mortality in women with epilepsy in Denmark was lower than what has previously been reported from United States and United Kingdom. However, the maternal mortality and especially the mortality in all women with epilepsy of childbearing age were considerably higher compared to women without epilepsy suggesting a need for improved care in women with epilepsy. Funding: The study was supported by the Lundbeck Foundation, the Novo Nordisk Foundation (NNF16OC0019126), and the Danish Epilepsy Association.