{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T21:57:51Z","timestamp":1790805471994,"version":"4.1.0"},"reference-count":66,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T00:00:00Z","timestamp":1750032000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective(s)<\/jats:title><jats:p>Pregnancy in women with epilepsy is associated with adverse perinatal outcomes, but debate remains as to role of epilepsy or of prenatal antiseizure medication (ASM), or both. We aimed to investigate the association between maternal epilepsy and perinatal outcomes, and to explore the role of prenatal ASM exposure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective population\u2010based cohort study using linked routinely\u2010collected health data (Scotland, 2009\u20132021). We included women with at least one singleton pregnancy. Our exposures included (1) maternal epilepsy, identified using International Classification of Diseases, Tenth Revision codes; (2) prenatal ASM, defined as dispensed within the prenatal period. We conducted multi\u2010level multiple regressions accounting for covariates and multiple pregnancies comparing: (1) women with (WWE) and without epilepsy (WWoE), (2) all pregnancies exposed and unexposed to prenatal ASMs, and (3) individual prenatal ASM monotherapy vs without ASM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 629\u2009200 pregnancies occurred from 2009\u20132021 (WWE\u2009=\u20092022, WWoE\u2009=\u2009627\u2009178; with ASM\u2009=\u20094406, without ASM\u2009=\u2009624\u2009794). WWE had increased odds of preterm birth, induced labor, cesarean section, preeclampsia, neonatal intensive care unit admission, low birth weight, and 5\u2010min Apgar score &lt;7. In fully adjusted models, only induced labor adjusted odds ratio aOR [95 CI]b 1.17 (95% confidence interval [CI]: 1.02\u20131.34) remained associated. Compared to women without ASM, those with ASM had increased odds of preterm birth (aOR 1.47, 95% CI: 1.25\u20131.74), induced labor (1.38, 1.25\u20131.52), cesarean section (1.14, 1.01\u20131.27), neonatal congenital conditions (1.34, 1.04\u20131.73), neonatal intensive care unit admission (1.54, 1.33\u20131.78), and low birthweight (1.47, 1.23\u20131.75). Increased odds were also observed for specific ASM monotherapies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Maternal epilepsy is associated with many adverse perinatal outcomes, but most are driven by prenatal ASM exposure. We postulate that joint comprehensive care between obstetricians and epileptologists or other specialists who prescribe ASMs could improve perinatal outcomes. Research into models of care and prescribers and the effect on outcomes is needed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.18484","type":"journal-article","created":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T10:25:56Z","timestamp":1750069556000},"page":"3353-3368","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Association of maternal epilepsy with perinatal outcomes, and an exploration of prenatal antiseizure medication: A population\u2010based retrospective cohort study"],"prefix":"10.1111","volume":"66","author":[{"given":"Paolo Pieirino","family":"Mazzone","sequence":"first","affiliation":[{"name":"Muir Maxwell Epilepsy Centre University of Edinburgh  Edinburgh UK"},{"name":"Child Life and Health, Centre for Inflammation Research University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Stephen","sequence":"additional","affiliation":[{"name":"Edinburgh Clinical Trials Unit, Usher Institute University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J.","family":"Weir","sequence":"additional","affiliation":[{"name":"Muir Maxwell Epilepsy Centre University of Edinburgh  Edinburgh UK"},{"name":"Edinburgh Clinical Trials Unit, Usher Institute University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sohinee","family":"Bhattacharya","sequence":"additional","affiliation":[{"name":"Aberdeen Centre for Women's Health Research, The Institute of Applied Health Sciences University of Aberdeen  Aberdeen UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mairead","family":"Black","sequence":"additional","affiliation":[{"name":"Aberdeen Centre for Women's Health Research, The Institute of Applied Health Sciences University of Aberdeen  Aberdeen UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard F. 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