{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T07:51:16Z","timestamp":1749801076922,"version":"3.40.5"},"reference-count":42,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2024,4,1]],"date-time":"2024-04-01T00:00:00Z","timestamp":1711929600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002322","name":"CAPES","doi-asserted-by":"crossref","award":["23038.003092\/2014-61, 523\/2014"],"award-info":[{"award-number":["23038.003092\/2014-61, 523\/2014"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>This retrospective cohort study described the obstetric and neonatal outcomes, antiseizure medication (ASM) use, and types of seizures in pregnant women with epilepsy (PWWE). Data collected from the medical records of 224 PWWE aged &lt; 40 years with controlled or refractory seizures and 492 pregnant women without epilepsy (PWNE) control group from high-risk maternity hospitals in Alagoas between 2008 and 2021 were included in this study. The obstetric and neonatal outcomes observed in PWWE were pregnancy-related hypertension (PrH) (18.4%), oligohydramnios (10.3%), stillbirth (6.4%), vaginal bleeding (6%), preeclampsia (4.7%), and polyhydramnios (3%). There was a greater likelihood of PrH in PWWE with generalized tonic-clonic seizures (GTCS) and that of maternal intensive care unit (ICU) admissions in those with GTCS and status epilepticus, and phenytoin and lamotrigine use. PWWE with GTCS had a higher risk of stillbirth and premature delivery. PWWE with status epilepticus were treated with lamotrigine. Phenobarbital (PB) with diazepam were commonly used in GTCS and status epilepticus. Total 14% patients did not use ASM, while 50.2% used monotherapy and 35.8% used polytherapy. Total 60.9% of patients used PB and 25.2% used carbamazepine. This study described the association between the adverse obstetric and neonatal outcomes and severe seizure types in PWWE.<\/jats:p>","DOI":"10.1371\/journal.pone.0291190","type":"journal-article","created":{"date-parts":[[2024,4,1]],"date-time":"2024-04-01T17:43:59Z","timestamp":1711993439000},"page":"e0291190","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Obstetric and neonatal outcomes, antiseizure medication profile, and seizure types in pregnant women in a vulnerability state from Brazil"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5465-9287","authenticated-orcid":true,"given":"Magn\u00facia de Lima","family":"Leite","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatiana Natasha","family":"Topocov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tales Lyra","family":"de Oliveira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8488-5990","authenticated-orcid":true,"given":"Daniel dos Santos","family":"Almeida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra Regina","family":"Mota Ortiz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Claudio","family":"da Silva","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,4,1]]},"reference":[{"issue":"4","key":"pone.0291190.ref001","first-page":"522","article-title":"Operational classification of seizure types by the International League Against Epilepsy. Epileptic seizures and epilepsy: definitions proposed by the international league against epilepsy (ILAE) and th international bureau for epilepsy (IBE).","volume":"58","author":"RS Fisher","year":"2017","journal-title":"Epilepsia"},{"issue":"4","key":"pone.0291190.ref002","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1111\/j.1528-1167.2010.02522.x","article-title":"Revised terminology and concepts for organization of seizures and epilepsies: report of the ILAE Commission on Classifi cation and Terminology, 2005\u20132009","volume":"51","author":"AT Berg","year":"2010","journal-title":"Epilepsia"},{"issue":"9971","key":"pone.0291190.ref003","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1016\/S0140-6736(14)60456-6","article-title":"Epilepsy: new advances.","volume":"385","author":"SL Mosh\u00e9","year":"2015","journal-title":"Lancet"},{"issue":"6","key":"pone.0291190.ref004","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1684\/epd.2019.1105","article-title":"Management of epilepsy in pregnancy: a report of the International League Against Epilepsy Task Force on Women and Pregnancy.","volume":"21","author":"T Tomson","year":"2019","journal-title":"Epileptic disorder."},{"issue":"13","key":"pone.0291190.ref005","doi-asserted-by":"crossref","first-page":"1736","DOI":"10.1111\/j.1471-0528.2009.02354.x","article-title":"Complications during pregnancy in women with epilepsy: a population-based cohort study.","volume":"116","author":"I Borthen","year":"2009","journal-title":"THE BJOG"},{"issue":"8","key":"pone.0291190.ref006","first-page":"e173","article-title":"Withdrawal of valproic acid treatment during pregnancy and seizure outcome: Observations from EURAP Epilepsia","volume":"57","author":"T Tomson","year":"2016"},{"issue":"1","key":"pone.0291190.ref007","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1111\/j.1528-1167.2006.00386.x","article-title":"Prospective and controlled study of the obstetric and neonatal outcome of 179 pregnancies in women with epilepsy","volume":"47","author":"K Viinikainen","year":"2006","journal-title":"Epilepsia, epilepsia"},{"issue":"4","key":"pone.0291190.ref008","doi-asserted-by":"crossref","first-page":"e 020998","DOI":"10.1136\/bmjopen-2017-020998","article-title":"Hypertensive pregnancy complications in women with epilepsy and antiepileptic drugs: a population-based cohort study of first pregnancies in Norway","volume":"8","author":"KC Danielson","year":"2018","journal-title":"BMJ Open"},{"issue":"9","key":"pone.0291190.ref009","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1001\/jamaneurol.2015.1017","article-title":"Mortality and morbidity during inpatient delivery in pregnant women with epilepsy in the United States","volume":"72","author":"SC MacDonald","year":"2015","journal-title":"JAMA Neurol"},{"key":"pone.0291190.ref010","article-title":"Women treated for epilepsy during pregnancy: outcomes from a nationwide population-based cohort study.","author":"M Artama","year":"2017","journal-title":"Acta Obstet Gynecol Scand."},{"issue":"1","key":"pone.0291190.ref011","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1111\/j.1528-1167.2007.01412.x","article-title":"Seizure control in antiepileptic drug- treated pregnancy","volume":"49","author":"FJ Vajda","year":"2008","journal-title":"Epilepsia"},{"issue":"2","key":"pone.0291190.ref012","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1177\/1756285615623934","article-title":"Management of epilepsy during pregnancy: an update.","volume":"9","author":"Sima Patel","year":"2016","journal-title":"Ther Adv Neurol Disord"},{"volume-title":"Risk associated with epilepsy during pregnancy and postpartum period [Internet].","year":"2019","author":"P Pennell","key":"pone.0291190.ref013"},{"issue":"3","key":"pone.0291190.ref014","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/S0920-1211(02)00237-1","article-title":"Epilepsy and pregnancy: Report of Epilepsy Research Foundation Workshop","volume":"52","author":"C Barrett","year":"2003","journal-title":"Epilepsy Res"},{"issue":"2","key":"pone.0291190.ref015","first-page":"120","article-title":"Gravidez e epilepsia","volume":"10","author":"S Aguilar","year":"2016","journal-title":"Acta Obstet Ginecol Port"},{"issue":"8","key":"pone.0291190.ref016","doi-asserted-by":"crossref","first-page":"e 0214180","DOI":"10.1371\/journal.pone.0214180","article-title":"Relationship of in-utero exposure to antiepileptic drugs to duration and size of pregnancy at birth.","volume":"14","author":"AV Margulis","year":"2019","journal-title":"PLos One."},{"issue":"3","key":"pone.0291190.ref017","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1007\/s00415-013-7239-x","article-title":"Fetal growth restriction and birth defects with newer and older antiepileptic drugs during pregnancy","volume":"261","author":"G Veiby","year":"2014","journal-title":"J Neurol"},{"issue":"3","key":"pone.0291190.ref018","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1016\/j.reprotox.2012.05.038","article-title":"Preliminary findings of the developmental effects of in utero exposure to topiramate.","volume":"34","author":"T Rihtman","year":"2012","journal-title":"Reprod Toxicol"},{"volume-title":"Epilepsies: diagnosis and management","year":"2021","key":"pone.0291190.ref019"},{"issue":"5","key":"pone.0291190.ref020","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1136\/jnnp.2008.156109","article-title":"Folic acid use and major congenital malformations in offspring of women with epilepsy: a prospective study from the UK Epilepsy and Pregnancy Register","volume":"80","author":"JI Morrow","year":"2009","journal-title":"J Neurol Neurosurg Psychiatry"},{"journal-title":"tabnet.datasus.gov.br\/tabnet\/tabnet.htm.","year":"2021","author":"Minist\u00e9rio da Sa\u00fade","key":"pone.0291190.ref021"},{"key":"pone.0291190.ref022","first-page":"108p","author":"IBGE","year":"2016","journal-title":"Pesquisa nacional por amostra de domic\u00edlios: s\u00edntese de indicadores 2015 \/ IBGE, Coordena\u00e7\u00e3o de Trabalho e Rendimento\u2014Rio de Janeiro: IBGE"},{"issue":"8","key":"pone.0291190.ref023","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":"N Razaz","year":"2017","journal-title":"JAMA Neurol"},{"issue":"19","key":"pone.0291190.ref024","doi-asserted-by":"crossref","first-page":"e119","DOI":"10.3346\/jkms.2020.35.e119","article-title":"Pregnancy and Epilepsy: a Korean Tertiary Epilepsy Center Review.","volume":"35","author":"JY Jeon","year":"2020","journal-title":"J Korean Med Sci."},{"issue":"1","key":"pone.0291190.ref025","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1186\/s12884-018-1857-3","article-title":"Obstetric outcomes and effects on babies born to women treated for epilepsy during pregnancy in a resource limited setting: a comparative cohort study.","volume":"18","author":"P Galappatthy","year":"2018","journal-title":"BMC Pregnancy Childbirth."},{"issue":"2","key":"pone.0291190.ref026","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.seizure.2009.11.008","article-title":"Pregnancy with epilepsy: obstetric and neonatal outcome of a controlled study.","volume":"19","author":"G Mawer","year":"2010","journal-title":"Seizure"},{"key":"pone.0291190.ref027","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.seizure.2019.05.009","article-title":"Outcomes of pregnant women with refractory epilepsy.","volume":"69","author":"B Kusznir Vitturi","year":"2019","journal-title":"Seizure"},{"issue":"74","key":"pone.0291190.ref028","first-page":"9922","article-title":"Epilepsy on high-risk pregnancy and perinatal outcomes","volume":"12","author":"R.C Packer","year":"2022","journal-title":"Sa\u00fade Colet"},{"key":"pone.0291190.ref029","first-page":"101","article-title":"Taxas de cesariana em hospitais p\u00fablicos e privados: um estudo transversal.","volume":"51","author":"BD Ces\u00e1rea no BrasiL Alonso","year":"2017","journal-title":"Rev Saude Publica"},{"issue":"7","key":"pone.0291190.ref030","doi-asserted-by":"crossref","first-page":"e 0271328","DOI":"10.1371\/journal.pone.0271328","article-title":"Socio-demographic profiles and obstetrics outcomes of pregnant women with epilepsy in a vulnerability State, Brazil.","volume":"17","author":"M De Lima Leite","year":"2022","journal-title":"PLoS One."},{"key":"pone.0291190.ref031","doi-asserted-by":"crossref","first-page":"106566","DOI":"10.1016\/j.eplepsyres.2021.106566","article-title":"Peripartum hemorrhage and other obstetric and neonatal outcomes in pregnant women with epilepsy: A single-center study","volume":"171","author":"MM I\u015f\u0131kalan","year":"2021","journal-title":"Epilepsy Res"},{"issue":"1","key":"pone.0291190.ref032","doi-asserted-by":"crossref","first-page":"62","DOI":"10.5603\/PJNNS.a2020.0003","article-title":"Obstetric and neonatal outcomes in women with epilepsy in Poland\u2014a two-centre study.","volume":"54","author":"M Bosak","year":"2020","journal-title":"Neurol Neurochir Pol."},{"key":"pone.0291190.ref033","first-page":"6","article-title":"Antiepileptic drugs and fetal malformation: analysis of 20 years of data in a pregnancy registry.","volume":"65","author":"FJE Vajda","year":"2019","journal-title":"Convulsion"},{"issue":"12","key":"pone.0291190.ref034","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.1136\/jnnp-2017-317368","article-title":"Changing trends in prescribing anti-epilepsy drugs in women with epilepsy in the UK and Ireland and the impact on major congenital malformations","volume":"89","author":"MO Kinney","year":"2018","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"10006","key":"pone.0291190.ref035","doi-asserted-by":"crossref","first-page":"1845","DOI":"10.1016\/S0140-6736(15)00045-8","article-title":"Epilepsy in pregnancy and reproductive outcomes: systematic review and meta-analysis","volume":"386","author":"L Viale","year":"2015","journal-title":"Lancet"},{"issue":"9","key":"pone.0291190.ref036","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.1111\/epi.12302","article-title":"Seizure control and treatment changes in pregnancy: observations from the EURAP epilepsy pregnancy registry","volume":"54","author":"D Battino","year":"2013","journal-title":"Epilepsia"},{"issue":"2","key":"pone.0291190.ref037","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1212\/WNL.0b013e3181a6b325","article-title":"Practice parameter update: management issues for womenwithepilepsy\u2014focus on pregnancy (anevidence-based review): vitamin K, folicacid, bloodlevels, and breast feeding: report of the Quality Standards Subcommittee and Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and American Epilepsy Society.","volume":"73","author":"CL Harden","year":"2009","journal-title":"Neurology"},{"key":"pone.0291190.ref038","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.seizure.2015.02.030","article-title":"Folic acid supplementation in women with epilepsy: are we sure it\u2019s safe?","volume":"27","author":"AA Asadi-Pooya","year":"2015","journal-title":"Seizure"},{"issue":"6","key":"pone.0291190.ref039","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1016\/S1474-4422(18)30107-8","article-title":"Comparative risk of major congenital malformations with eight different antiepileptic drugs: a prospective cohort study of the EURAP registry","volume":"17","author":"T Tomson","year":"2018","journal-title":"Lancet Neurol"},{"issue":"8","key":"pone.0291190.ref040","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1212\/WNL.0000000000003637","article-title":"Predictors. of unintended pregnancy in women with epilepsy","volume":"88","author":"AG Herzog","year":"2017","journal-title":"Neurology"},{"issue":"3","key":"pone.0291190.ref041","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.3390\/ijms23031369","article-title":"Epilepsy in Pregnancy\u2014Management Principles and Focus on Valproate.","volume":"23","author":"B B\u0142aszczyk","year":"2022","journal-title":"Int J Mol Sci."},{"issue":"7","key":"pone.0291190.ref042","doi-asserted-by":"crossref","first-page":"e 729","DOI":"10.1212\/WNL.0000000000008757","article-title":"Effects of periconceptional folate on cognition in children of women with epilepsy: NEAD study","volume":"94","author":"KJ Meador","year":"2020","journal-title":"Neurology"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0291190","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,1]],"date-time":"2024-04-01T17:44:22Z","timestamp":1711993462000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0291190"}},"subtitle":[],"editor":[{"given":"Dragan","family":"Hrncic","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,4,1]]},"references-count":42,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,4,1]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0291190","relation":{},"ISSN":["1932-6203"],"issn-type":[{"type":"electronic","value":"1932-6203"}],"subject":[],"published":{"date-parts":[[2024,4,1]]}}}