scholarly journals Seizure frequency and obstetric complications at advanced maternal age: a preliminary observational study in women with epilepsy

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Hui Gao ◽  
Nanya Hao ◽  
Shanrui Liu ◽  
Dong Zhou
Keyword(s):  
Seizure Frequency ◽  
Maternal Age ◽  
Seizure Control ◽  
Advanced Maternal Age ◽  
Obstetric Complications ◽  
Obstetric Outcomes ◽  
Treatment Change ◽  
Hospital Patients ◽  
Patients With Epilepsy

Abstract Background Seizure control during pregnancy and obstetric outcomes are of important concerns for women with epilepsy (WWE) and their families. Advanced maternal age (≥35 years) shows a growing trend in the society with changes of lifestyle, which also occurs in diseased populations. The advanced maternal age is an independent factor for some unsatisfying obstetric outcomes. In this study we explored the seizure control and obstetric complications associated with advanced maternal age in WWE. Methods This study was based on the epilepsy pregnancy registry at West China Hospital. Patients with epilepsy in this registry who were aged 35 or older when starting pregnancy were included in this study. Their basic demographics and detailed information on epilepsy management and obstetric issues in all trimesters and during 1-year follow-up after birth were documented and reviewed. Data were processed by IBM SPSS version 22.0. The demographic characteristics, seizure frequency, treatment change, obstetric complications, and outcomes were analyzed and compared. Results Fifteen patients were included in this study, with an average age of 36.32 ± 2.39 years at pregnancy, and 73.33% of them were primiparas. The change of seizure frequency during pregnancy was not in a clear pattern, but there was an increased incidence of tonic-clonic seizures during the mid- and last trimesters. More than 20% of the patients had obstetric complications throughout the trimesters, including vaginal bleeding, hypothyroidism, and pre-eclampsia. The pre-eclampsia seemed extraordinarily complicated with other conditions. However, none of the complications were related with malformations or poor outcome of babies after 1-year follow-up. Conclusion Advanced maternal age combined with WWE is associated with frequent common obstetric complications. Future controlled studies with large sample sizes are needed to explore the related risks in comparison with other WWE and non-epileptic populations.

Adverse Obstetric Outcomes at Advanced Maternal Age in Arba Minch Zuria, and Gacho Baba District, Southern Ethiopia: A Prospective Cohort Study

2020 ◽  
Author(s):  
Abera Mersha ◽  
Gistane Ayele ◽  
Tilahun Worku ◽  
Zerihun Zerdo ◽  
Shitaye Shibiru ◽  
...  
Keyword(s):  
Maternal Age ◽  
Open Data ◽  
Advanced Maternal Age ◽  
Obstetric Outcomes ◽  
Hypertensive Disorder ◽  
Increased Risk ◽  
The Status ◽  
Study Participants ◽  
Open Data Kit

Abstract Background: Advanced maternal age significantly increased the risk of adverse obstetric outcomes. So, adequate and updated information on the status of advanced maternal age and their effect on obstetric outcomes is vital for effective policy and program formulation in Ethiopia. Pockets of studies conducted, but most are retrospective and record reviews. Thus, studies that show the status of advanced maternal age and their effect on obstetric outcomes is very limited in Ethiopia. As such, this study fills those gaps in our set up.Methods: A community-based prospective cohort study was conducted among 709 study participants from October 15, 2018, to September 30, 2019. A pretested interviewer-administered structured Open Data Kit survey tool was used to collect the data. The downloaded data from the Open Data Kit aggregate was exported to SPSS version 25 for analysis. Log-linear regression was used to compare obstetric outcomes among women aged 20–34 years and ≥ 35 years. The model was adjusted for educational and occupational status, party, wealth index, body mass index, household food insecurity, habits, distance to health care institution, and sex of the neonate, antenatal care, postnatal care, and place of delivery. The model fitness was tested by the log-likelihood ratio.Results: In this study, 209(29.5%) of the women were aged ≥ 35 years, and 500(70.5%) aged 20–34 years. Women aged ≥ 35 years were at increased risk of miscarriage (β = 0.29, 95%CI: 0.02, 0.56), and hypertensive disorder (β = 0.07, 95%CI: 0.004, 0.13).Conclusions: Advanced maternal age was independently associated with miscarriage and hypertensive disorder after controlling for possible cofounders. As such, different intervention programs should be designed to create awareness and to provide counseling services for women with advanced age or delayed childbearing.Plain English summaryWomen who bear a child at the age of ≥35 years old are stated as advanced maternal age. At this age, the risk of different obstetric complications is increased. This study was aimed to assess the effect of advanced maternal age on obstetric outcomes in the study settings.A prospective follow-up study was conducted among pregnant women during the study period. The women were followed from the time pregnancy was confirmed up to the immediate postpartum period. Seven hundred forty-four women were interviewed in the baseline and 24 participants became lost to follow-ups during the follow-up period, and 11 excluded from the analysis because of incomplete information.Of the study participants, 209 of the women were beard children at the age of ≥35 years (advanced maternal age), and 500 were age group from 20-34 years old.This study found that advanced maternal age increased risk of miscarriage (termination of pregnancy before fetal viability) and hypertensive disorder during pregnancy, the intrapartum and immediate postpartum period after controlled for possible confounders.In brief, this study showed that a significant number of women became pregnant during advanced maternal age. Therefore, different strategies should be designed for the women who planned to bear child, and information should be provided for women who are advanced age or delayed childbearing to alert them.

scholarly journals Impact of aging on obstetric outcomes: defining advanced maternal age in Barcelona

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Marta Claramonte Nieto ◽  
Eva Meler Barrabes ◽  
Sandra Garcia Martínez ◽  
Mireia Gutiérrez Prat ◽  
Bernat Serra Zantop
Keyword(s):  
Risk Factor ◽  
Gestational Diabetes ◽  
Maternal Age ◽  
Placenta Previa ◽  
Significant Risk ◽  
Advanced Maternal Age ◽  
Obstetric Outcomes ◽  
Chronic Hypertension ◽  
Mediterranean Population ◽  
Confounding Factors

Abstract Background Women of advanced maternal age (AMA) are a growing population, with higher obstetric risks. The Mediterranean population has specific characteristics different from other areas. Thus, the objective of this study was to establish a cut-off to define AMA in a selected mediterranean population coming from a tertiary referral private/mutual health hospital in Barcelona. Methods Retrospective cohort of euploid singleton pregnancies delivered from January 2007 to June 2017. Main maternal outcomes were: gestational diabetes, preeclampsia, placenta previa, c-section and prolonged hospitalization (≥ 7 days). Main adverse perinatal outcomes were: stillbirth, prematurity, preterm prelabor rupture of membranes, low birth weight, need of admission at a neonatal intensive care unit and perinatal mortality. Adjustment for confounding factors (smoking, previous comorbilities, parity, assisted reproductive techniques (ART) and obesity) was performed. Results A total of 25054 pregnancies were included. Mean maternal age was 34.7 ± 4.2 years, with 2807 patients in the group of age between 40 and 44 years (11.2%) and 280 patients ≥45 years (1.1%). Women at AMA had higher incidence of previous comorbilities (compared to the reference group of women < 30 years): prior c-section, chronic hypertension and obesity. In addition, they were more likely to use ART. After adjusting for confounding factors, maternal age was an independent and statistically significant risk factor for gestational diabetes (OR 1.66/2.80/3.14) for ages 30–39, 40–44 and ≥ 45 years respectively, c-section (OR 1.28/2.41/7.27) and placenta previa (OR 2.56/4.83) for ages 40–44 and ≥ 45 years respectively, but not for preeclampsia (neither early-onset nor late-onset). Risk of emergency c-section was only increased in women ≥45 years (OR, 2.03 (95% CI, 1.50–2.74). In the other groups of age, the increase in c-section rate was because of elective indications. Age ≥ 45 years was associated with iatrogenic prematurity < 37 weeks (OR 2.62, 95% CI 1.30–5.27). No other relevant associations between AMA and maternal or neonatal outcomes were found. Conclusions Maternal age is an independent risk factor for adverse obstetric outcomes. Age ≥ 40 years was associated to relevant increased risks and reveals to be an adequate cut-off to define AMA in our population.

scholarly journals The effects of epileptic seizures upon quality of life

2009 ◽  
Vol 15 (3) ◽  
pp. 110-113 ◽  
Author(s):  
Priscila Camile Barioni Salgado ◽  
Fernando Cendes
Keyword(s):  
Quality Of Life ◽  
Seizure Frequency ◽  
Seizure Control ◽  
Epileptic Seizures ◽  
Anxiety And Depression ◽  
Co Morbidity ◽  
Item Quality ◽  
Patients With Epilepsy ◽  
And Control

OBJECTIVE: understand the psychological considerations of the relationship between the effect of seizures upon the patients' perception of seizure control, depression, anxiety and quality of life (QoL). METHODS: 151 adult patients with epilepsy diagnosed for over two years were interviewed and responded the 31-Item Quality of Life in Epilepsy (QOLIE-31), the Trait Form of the State/Trait Anxiety Inventory (STAI II) and the Beck Depression Inventory (BDI). RESULTS: 45 patients were depressed (29.8%) and 29 (19.2%) had anxiety. Depression scores ranged from 0 to 49 (M=7.4; SD=8.9) and anxiety scores ranged from 19 to 69 (M=41.5, SD=11.9). Total QoL score was correlated to seizure control (p<0.001), perception of epilepsy control (p<0.001), anxiety (p<0.001), and depression (p=0.003). The perception of epilepsy control was correlated to seizure control (p<0.001), seizure frequency (p=0.001), anxiety (p<0.001) and depression (p<0.001). Seizure control was associated to anxiety (p=0.033) and depression (p<0.001). There was co-morbidity between anxiety and depression (p<0.001). CONCLUSION: This study highlights the importance of the seizure frequency and control to the evaluation of perception of epilepsy control and shows that anxiety and depression in epilepsy are predicted by seizure-related (seizure frequency and control) and psychosocial aspects (perception of control and QoL) together.

scholarly journals Clinical features and surgical outcome of patients with indolent brain tumors and epilepsy

2007 ◽  
Vol 13 (2) ◽  
pp. 65-69
Author(s):  
Julieta G. S. P. Melo ◽  
Ricardo S. Centeno ◽  
Suzana M. F. Malheiros ◽  
Fernando A. P. Ferraz ◽  
João N. Stávale ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Seizure Frequency ◽  
Seizure Control ◽  
Slow Growth ◽  
Young Patients ◽  
Biological Behavior ◽  
Surgical Removal ◽  
Cortical Gray Matter ◽  
History Of

INTRODUCTION: In this study the authors review the outcomes of 22 patients with medically refractory epilepsy and slow growth brain tumors. OBJECTIVES: Evaluate the clinical, electrophysiological, operative, and histopathological features. PATIENTS AND RESULTS: The majority of the tumors were located in the temporal lobe (n = 20) and involved the cortical gray matter. The most frequent tumors were gangliogliomas (n = 9), astrocytomas grade I and II (n = 6), dysembryoplastic neuroepithelial tumors (n = 5) and ganglioneuroma (n = 2). The biological behavior of the tumors was strikingly indolent, as indicated by a long preoperative history of chronic seizures (mean, 14 years). Mean follow-up time after resection was 27 months, and according to Engel’s classification, 85% were seizure-free, 10% showed a reduction of seizure frequency of at least 90%, and 5% had reduction in seizure frequency at least 75%. CONCLUSION: The data indicate that neoplasms associated with pharmacoresistent epilepsy constitute a distinct clinicopathological group of tumors that arise in young patients, involve the cortex, and exhibit indolent biological behavior for many years. Complete surgical removal of these tumors, including the epileptogenic area, can achieve excellent seizure control.

scholarly journals Obstetric outcomes of twin pregnancies at advanced maternal age: A retrospective study

2018 ◽  
Vol 57 (1) ◽  
pp. 64-67 ◽  
Author(s):  
Caixia Zhu ◽  
Malie Wang ◽  
Gang Niu ◽  
Juan Yang ◽  
Zilian Wang
Keyword(s):  
Retrospective Study ◽  
Maternal Age ◽  
Advanced Maternal Age ◽  
Obstetric Outcomes ◽  
Twin Pregnancies

scholarly journals MEMANTINE, AS A P-GLYCOPROTEIN EXPRESSION MODULATOR, ENHANCES LEVETIRACETAM THERAPEUTIC RESPONSE IN EPILEPTIC PATIENTS

2020 ◽  
pp. 104-108
Author(s):  
SAHAR AHMED HARBY ◽  
RASHA A NASSRA ◽  
JAIDAA F MEKKY ◽  
SAMIA M ALI ◽  
CHERINE A ISMAIL
Keyword(s):  
Therapeutic Response ◽  
Seizure Control ◽  
Multidrug Transporter ◽  
Potential Therapeutic Target ◽  
Glycoprotein P ◽  
P Glycoprotein ◽  
Epileptic Patients ◽  
Patients With Epilepsy ◽  
Transporter Expression

Objective: The principal aim of the present study was to assess the importance of multidrug transporter; P-glycoprotein (P-gp) as a potential therapeutic target in patients with epilepsy. Can P-gp transporter expression modulation by memantine add to the standard antiepileptic drugs (AEDs) response? Methods: A cohort of 56 epilepsy patients was included in a 4 monthly visits prospective study. Patients were on levetiracetam (LEV) 1000 mg/ day alone or combined with other AEDs. They were randomly assigned into two groups; LEV only group including LEV-treated patients and LEV + memantine group including patients on LEV with add-on oral memantine 10 mg/day until the end of the study. During monthly follow-up visits, therapeutic responses were evaluated for each patient by recording the monthly seizures frequency. Blood samples were drawn from every patient twice (on the first and last visits) for assessment of P-gp mRNA expression level. Results: Fifty patients completed the study. At the end of 4th month, LEV only group showed a non-significant decrease in P-gp expression and seizure frequency compared to the 1st month, whereas, in LEV + memantine group, P-gp expression was significantly reduced and associated with significant seizure control. Conclusion: Memantine by hindering P-gp overexpression was apt to enhance LEV efficacy and exhibit a better seizure control.

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