{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,31]],"date-time":"2025-05-31T04:11:04Z","timestamp":1748664664806,"version":"3.41.0"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:00:00Z","timestamp":1748563200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"crossref","award":["PR-PRU-1217-21202"],"award-info":[{"award-number":["PR-PRU-1217-21202"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec023\">\n<jats:title>Objectives<\/jats:title>\n<jats:p>To examine the prevalence of the maternal postnatal six-week check (SWC) in women with epilepsy compared to a sample of the postnatal population without epilepsy, and assess whether the SWC is associated with health outcomes in the first year postpartum.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec024\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Clinical Practice Research Datalink Aurum and Hospital Episode Statistics data were used to identify births between January1998-March2020 to women with epilepsy (n\u2009=\u200923,533) and a random sample of births to women without epilepsy (n\u2009=\u2009317,369). The adjusted risk ratio (aRR) for not having a SWC in women with compared to without epilepsy was estimated using modified Poisson regression. The association between receiving a SWC and postpartum health outcomes was assessed using Cox regression.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec025\">\n<jats:title>Results<\/jats:title>\n<jats:p>The likelihood of not having a SWC did not differ between those with and without epilepsy (42.7% vs 43.4%, aRR\u2009=\u20091.01, 95%CI\u2009=\u20090.99\u20131.03). Among all women, not having a SWC was associated with a lower subsequent likelihood of being prescribed prophylactic (aHR\u2009=\u20090.59, 95%CI\u2009=\u20090.58\u20130.60) and emergency (aHR\u2009=\u20090.95, 95%CI\u2009=\u20090.91\u20130.99) contraception and having urinary and\/or faecal incontinence (aHR\u2009=\u20090.67, 95%CI\u2009=\u20090.61\u20130.73) or dyspareunia, perineal and\/or pelvic pain (aHR\u2009=\u20090.70, 95%CI\u2009=\u20090.65\u20130.75) recorded in the year postpartum, with no evidence these associations differed according to whether a woman had epilepsy. Not having a SWC was also associated with a lower likelihood of having depression and\/or anxiety recorded in the first year postpartum among those without (aHR\u2009=\u20090.86, 95%CI\u2009=\u20090.84\u20130.89) but not with epilepsy (aHR\u2009=\u20091.01, 95%CI\u2009=\u20090.93\u20131.09). The SWC was not associated with epilepsy relevant outcomes (Accident and emergency visits or unplanned hospital admission for epilepsy, mortality).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec026\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Around 2 in every 5 women had no evidence of a maternal SWC, with no evidence epileptic women had a different prevalence to the general postnatal population. The maternal SWC may play a role in increasing the use of contraception and the detection or treatment of adverse health outcomes in the first year postpartum.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0323135","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T20:04:20Z","timestamp":1748635460000},"page":"e0323135","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["The maternal postnatal six-week check in women with epilepsy: Does the prevalence or subsequent postpartum health differ from the general postnatal population?"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6476-5307","authenticated-orcid":true,"given":"Kathryn E.","family":"Fitzpatrick","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8318-8421","authenticated-orcid":true,"given":"Liza","family":"Bowen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yangmei","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3717-8836","authenticated-orcid":true,"given":"Chun Hei","family":"Kwok","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fiona","family":"Alderdice","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suresha","family":"Dealmeida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris","family":"Gale","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Kenyon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8058-6181","authenticated-orcid":true,"given":"Maria A.","family":"Quigley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5712-9989","authenticated-orcid":true,"given":"Julia","family":"Sanders","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitrios","family":"Siassakos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5490-699X","authenticated-orcid":true,"given":"Claire","family":"Carson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,5,30]]},"reference":[{"issue":"9150","key":"pone.0323135.ref001","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/S0140-6736(05)74945-X","article-title":"What does postnatal care do for women\u2019s health?","volume":"353","author":"C MacArthur","year":"1999","journal-title":"Lancet"},{"key":"pone.0323135.ref002","author":"NHS BMA","year":"2020"},{"key":"pone.0323135.ref003","volume-title":"Postnatal care NICE guideline (NG194)","author":"National Institute for Health and Care Excellence.","year":"2021"},{"key":"pone.0323135.ref004","author":"Royal College of Obstetricians and Gynaecologists.","year":"2016","journal-title":"Epilepsy in Pregnancy Green-top Guideline"},{"key":"pone.0323135.ref005","author":"Medicines and Healthcare products Regulatory Agency.","year":"2024"},{"issue":"10006","key":"pone.0323135.ref006","doi-asserted-by":"crossref","first-page":"1845","DOI":"10.1016\/S0140-6736(15)00045-8","article-title":"Epilepsy in pregnancy and reproductive outcomes: a systematic review and meta-analysis","volume":"386","author":"L 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Knight","year":"2020"},{"key":"pone.0323135.ref010","volume-title":"Release Notes: CPRD Aurum September 2023","author":"Clinical Practice Research Datalink.","year":"2023"},{"issue":"6","key":"pone.0323135.ref011","doi-asserted-by":"crossref","first-page":"1740","DOI":"10.1093\/ije\/dyz034","article-title":"Data resource profile: Clinical Practice Research Datalink (CPRD) Aurum","volume":"48","author":"A Wolf","year":"2019","journal-title":"Int J Epidemiol"},{"issue":"1","key":"pone.0323135.ref012","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/s12963-023-00302-0","article-title":"Completeness, agreement, and representativeness of ethnicity recording in the United Kingdom\u2019s Clinical Practice Research Datalink (CPRD) and linked Hospital Episode Statistics (HES)","volume":"21","author":"SI Shiekh","year":"2023","journal-title":"Popul Health Metr"},{"key":"pone.0323135.ref013","article-title":"Methods to refine and extend a pregnancy register in the UK clinical 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