Seizure occurrence, pregnancy outcome among women with active convulsive epilepsy: One year prospective study

• We determined the prevalence and outcome of epilepsy among pregnant women.
• The prevalence of active convulsive epilepsy was found to be 3.33 per 1000 among the cohort.
• Subjects with previous head injury and encephalitis were more likely to have recurrent seizures.
• Subjects with prior recurrent seizures had poorer pregnancy outcome.
• Proper seizure control before and during pregnancy should be encouraged.

PurposeTo determine the prevalence of active convulsive epilepsy, seizure frequency and the outcome of pregnancy amongst a cohort of pregnant women attending antenatal clinic (ANC) at two tertiary hospitals.MethodsAn observational cohort study conducted at the University of Maiduguri Teaching Hospital and State Specialist Hospital, Northeast Nigeria. Pregnant women attending antenatal care were screened for previous history of active convulsive epilepsy, and recruited consecutively according to a specified protocol. A standardized questionnaire was administered to record pregnancy history, nature of epilepsy and treatments received. They were followed-up during the course of the pregnancy based on the ANC schedule up to delivery. The outcome of pregnancies was recorded.ResultsA total of 7063 pregnant women were screened, of whom 103 (1.46%) subjects had at least a past history of seizure. Seventy-eight (1.10%) had a past history of seizure(s) from eclampsia and 23 (0.33%) pregnant subjects recruited were identified to have active convulsive epilepsy. The unadjusted prevalence of active convulsive epilepsy in pregnant women was found to be 3.33 per 1000 (95% CI: 2.1–4.8). Subjects who had a history of head injury and encephalitis were more likely to have seizures during pregnancy. (P = 0.013 and P = 0.041). Those who had recurrent seizures within the last six months before recruitment were more likely to have a negative pregnancy outcome (P = 0.043).ConclusionOur study found a prevalence of active epilepsy of 3.33 per 1000 among pregnant women, with about one percent having a past history of seizure from eclampsia.