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Background and purpose  Studies in women with epilepsy ( WWE ) regarding pregnancy and labour complications have disclosed contradictory results. Our purpose was to investigate whether  WWE  have a higher risk of acute caesarean section ( CS ) or pregnancy complications than women without epilepsy or women with other chronic diseases and, if we found a higher risk, to explore potential explanations.    Methods  The study used prospectively registered obstetric data from the Oppland Perinatal Database in the period 2001–2011, containing information on 18 244 births, including 110 singleton pregnancies in mothers with validated epilepsy. Data regarding epilepsy were collected retrospectively from medical records.    Results  Epilepsy was a significant risk factor for acute  CS , breech presentation and low birth weight in offspring [odds ratio ( OR),  1.93, 95% confidence interval (CI), 1.2–3.1;  OR,  2.29, 95%  CI,  1.2–4.6 and  OR,  2.10, 95%  CI,  1.0–4.2, respectively]. In multivariate logistic regression analysis, antiepileptic drug exposure was an independent risk factor for acute  CS  ( OR,  2.00; 95%  CI,  1.06–3.77) and polytherapy was a significant risk factor for breech presentation ( OR,  5.37; 95%  CI,  1.13–25.57). Seizure frequency during pregnancy had no influence on the complication rate.    Conclusions  We found that WWE using antiepileptic drugs during pregnancy had increased rates of acute  CS , breech presentation and low birth weight, and that seizure frequency during pregnancy did not influence the complication rate.

Increased rate of acute caesarean sections in women with epilepsy: results from the Oppland Perinatal Database in Norway