{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T01:10:47Z","timestamp":1780708247924,"version":"3.54.1"},"reference-count":33,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,3,28]]},"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To estimate the risk of hypertensive pregnancy complications in women with epilepsy, with and without antiepileptic drugs, and assess the risk associated with the four most common antiepileptic drugs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A population-based cohort study using linked data from the Medical Birth Registry of Norway and the Norwegian Prescription Database. Women with epilepsy with and without antiepileptic drugs were compared with women without epilepsy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Norway, 2004\u20132012.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>All first pregnancies of women with epilepsy and women without epilepsy were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Main outcome measures were hypertensive pregnancy complications: a compound variable of any hypertensive disorder, gestational hypertension, mild pre-eclampsia, severe pre-eclampsia, early onset pre-eclampsia, eclampsia and HELLP syndrome (haemolysis, elevated liver enzymes, low platelets).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 1778 pregnancies in women with epilepsy and 221 662 in women without epilepsy were analysed. 682 of the women with epilepsy used antiepileptic drugs, the most common in monotherapy being: lamotrigine (n=280), carbamazepine (n=94), levetiracetam (n=71) and valproate (n=51). There was an increased risk of any hypertensive disorder in women with epilepsy (adjusted OR (aOR) 1.2, 95%\u2009CI 1.0 to 1.5) and in the subcategory using valproat (aOR 2.9, 95%\u2009CI 1.3 to 6.4). The most frequent hypertensive complication was mild pre-eclampsia and the risk was increased in women with epilepsy (aOR 1.4, 95%\u2009CI 1.1 to 1.8) and women with epilepsy with valproat (aOR 3.3, 95%\u2009CI 1.2 to 9.4).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Women with epilepsy have an increased risk of mild pre-eclampsia, but not for the severe types of hypertensive pregnancy complications. Lamotrigine and levetiracetam do not predispose for mild pre-eclampsia, whereas valproate was associated with an increased risk of mild pre-eclampsia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-020998","type":"journal-article","created":{"date-parts":[[2018,4,24]],"date-time":"2018-04-24T12:46:38Z","timestamp":1524573998000},"page":"e020998","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":30,"title":["Hypertensive pregnancy complications in women with epilepsy and antiepileptic drugs: a population-based cohort study of first pregnancies in Norway"],"prefix":"10.1136","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1090-0590","authenticated-orcid":false,"given":"Kim Christian","family":"Danielsson","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway"},{"name":"Department of Clinical Medicine, University of Bergen, Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid","family":"Borthen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, University of Bergen, Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils-Halvdan","family":"Morken","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway"},{"name":"Department of Clinical Science, University of Bergen, Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils Erik","family":"Gilhus","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, University of Bergen, Bergen, Norway"},{"name":"Department of Neurology, Haukeland University Hospital, Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,4,24]]},"reference":[{"key":"2025121509195893000_8.4.e020998.1","doi-asserted-by":"publisher","DOI":"10.1007\/s40264-013-0052-8"},{"key":"2025121509195893000_8.4.e020998.2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2009.02354.x"},{"key":"2025121509195893000_8.4.e020998.3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2011.03004.x"},{"key":"2025121509195893000_8.4.e020998.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2003.09.020"},{"key":"2025121509195893000_8.4.e020998.5","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD010224.pub2"},{"key":"2025121509195893000_8.4.e020998.6","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD010236.pub2"},{"key":"2025121509195893000_8.4.e020998.7","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1212\/CON.0000000000000270","article-title":"Managing epilepsy in women","volume":"22","author":"Gerard","year":"2016","journal-title":"Continuum"},{"key":"2025121509195893000_8.4.e020998.8","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.seizure.2015.02.019","article-title":"Major congenital malformations in children of women with epilepsy","volume":"28","author":"Tomson","year":"2015","journal-title":"Seizure"},{"key":"2025121509195893000_8.4.e020998.9","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(14)70227-X"},{"key":"2025121509195893000_8.4.e020998.10","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1001\/jamaneurol.2015.1017","article-title":"Mortality and morbidity during delivery hospitalization among pregnant women with epilepsy in the United States","volume":"72","author":"MacDonald","year":"2015","journal-title":"JAMA Neurol"},{"key":"2025121509195893000_8.4.e020998.11","doi-asserted-by":"crossref","unstructured":"Viale L , Allotey J , Cheong-See F , et al . Epilepsy in pregnancy and reproductive outcomes: a systematic review and meta-analysis. Lancet 2015;386.doi:10.1016\/S0140-6736(15)00045-8","DOI":"10.1016\/S0140-6736(15)00045-8"},{"key":"2025121509195893000_8.4.e020998.12","doi-asserted-by":"crossref","first-page":"2130","DOI":"10.1111\/j.1528-1167.2009.02147.x","article-title":"Pregnancy, delivery, and outcome for the child in maternal epilepsy","volume":"50","author":"Veiby","year":"2009","journal-title":"Epilepsia"},{"key":"2025121509195893000_8.4.e020998.13","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1080\/00016340600604625","article-title":"Pregnancy, delivery, and neonatal complications after treatment with antiepileptic drugs","volume":"85","author":"Pilo","year":"2006","journal-title":"Acta Obstet Gynecol Scand"},{"key":"2025121509195893000_8.4.e020998.14","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2006.00386.x"},{"key":"2025121509195893000_8.4.e020998.15","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1001\/jamaneurol.2017.1310","article-title":"Association between pregnancy and perinatal outcomes among women with epilepsy","volume":"74","author":"Razaz","year":"2017","journal-title":"JAMA Neurol"},{"key":"2025121509195893000_8.4.e020998.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2013.08.016"},{"key":"2025121509195893000_8.4.e020998.17","doi-asserted-by":"publisher","DOI":"10.1111\/epi.12711"},{"key":"2025121509195893000_8.4.e020998.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2012.04.014"},{"key":"2025121509195893000_8.4.e020998.19","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000437382.03963.88"},{"key":"2025121509195893000_8.4.e020998.20","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.eplepsyres.2011.07.006","article-title":"A meta-analysis of polycystic ovary syndrome in women taking valproate for epilepsy","volume":"97","author":"Hu","year":"2011","journal-title":"Epilepsy Res"},{"key":"2025121509195893000_8.4.e020998.21","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7827-11-56"},{"key":"2025121509195893000_8.4.e020998.22","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199311043291904"},{"key":"2025121509195893000_8.4.e020998.23","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(11)70107-7"},{"key":"2025121509195893000_8.4.e020998.24","unstructured":"Agency EM . CMDh agrees to strengthen warnings on the use of valproate medicines in women and girls: European Medicines Agency 2014. 2017 http:\/\/www.ema.europa.eu\/ema\/index.jsp?curl=pages\/news_and_events\/news\/2014\/11\/news_detail_002220.jsp&mid=WC0b01ac058004d5c1."},{"key":"2025121509195893000_8.4.e020998.25","doi-asserted-by":"crossref","first-page":"2305","DOI":"10.1111\/j.1528-1167.2009.02093.x","article-title":"Utilization of antiepileptic drugs during pregnancy: comparative patterns in 38 countries based on data from the EURAP registry","volume":"50","author":"Eurap Study Group","year":"2009","journal-title":"Epilepsia"},{"key":"2025121509195893000_8.4.e020998.26","unstructured":"Wilcox AJ . Fertility and pregnancy: an epidemiologic perspective. Oxford: Oxford University Press, USA, 2010."},{"key":"2025121509195893000_8.4.e020998.27","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1111\/aogs.13066","article-title":"Risk factors for recurrence of hypertensive disorders of pregnancy, a population-based cohort study","volume":"96","author":"Ebbing","year":"2017","journal-title":"Acta Obstet Gynecol Scand"},{"key":"2025121509195893000_8.4.e020998.28","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2255"},{"key":"2025121509195893000_8.4.e020998.29","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.12159"},{"key":"2025121509195893000_8.4.e020998.30","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3016.2012.01260.x"},{"key":"2025121509195893000_8.4.e020998.31","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2013.05.005"},{"key":"2025121509195893000_8.4.e020998.32","doi-asserted-by":"crossref","first-page":"1849","DOI":"10.1111\/epi.13573","article-title":"Overweight in epilepsy as a risk factor for pregnancy and delivery complications","volume":"57","author":"Kolstad","year":"2016","journal-title":"Epilepsia"},{"key":"2025121509195893000_8.4.e020998.33","unstructured":"WHO. Obesity health topic: World Health Organization;. 2017 http:\/\/www.who.int\/topics\/obesity\/en\/ (cited Jun 2017)."}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2017-020998","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T17:20:11Z","timestamp":1765819211000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2017-020998"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,4]]},"references-count":33,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2018,4,24]]},"published-print":{"date-parts":[[2018,4]]}},"alternative-id":["10.1136\/bmjopen-2017-020998"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2017-020998","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,4]]}}}