Psychiatric comorbidity and social aspects in pregnant women with epilepsy — The Norwegian Mother and Child Cohort Study

• Epilepsy is associated with psychiatric disease and adverse social aspects before and during pregnancy.
• Antiepileptic drugs have a positive modulating effect on psychiatric comorbidity.
• Adverse social aspects are more pronounced in untreated epilepsy.
• Polytherapy with antiepileptic drugs is associated with poorer social functioning during pregnancy.
• Psychiatric comorbidity should be considered when planning treatment for epilepsy in pregnant women.

ObjectiveThe objective of this study was to investigate psychiatric disease and social aspects in young women with epilepsy before and during pregnancy.MethodThe study included self-reported data from 106,935 pregnancies.ResultsSeven hundred eleven women reported having epilepsy, and 45.9% of them were using antiepileptic drugs (AEDs). Compared to the reference group, self-reported eating disorders and depression were increased in the untreated epilepsy group before pregnancy. Both AED-treated and untreated women with epilepsy reported higher depression scores as assessed by the Hopkins Symptom Checklist, and the Lifetime Major Depression scale was increased in AED-treated women. Antiepileptic drug treatment was linked to low income (27.4% vs. 18.4%, p < 0.001) and no income (5.5% vs. 2.6%, p = 0.001). Low educational level was associated with epilepsy in AED-treated and untreated women (50.5%, p < 0.001 and 46.9%, p < 0.001 vs. 32.2%), as was unemployment due to disability (7.9%, p < 0.001 and 6.5%, p < 0.001 vs. 1.5%) and single parenting (4.4%, p = 0.016 and 4.5%, p = 0.007 vs. 2.4%). No difference was found for smoking, alcohol use, or narcotic use.ConclusionSymptoms of depression were associated with epilepsy both during and before pregnancy. Epilepsy was linked to eating disorders before pregnancy. Unemployment, single parenting, and low educational level were linked to epilepsy in young pregnant females. Efforts aiming at treatment and screening for psychiatric comorbidity in pregnant women with epilepsy are important in the follow-up of these patients.