@article{eb0a4dd025c945359606abffdf8fa409,
title = "Neurological factors and Cesarean section in Australian women with epilepsy",
abstract = "Objectives: To analyze the records of the pregnancies of 2283 Australian women with epilepsy in the Australian Register of Antiepileptic Drugs in Pregnancy database to identify neurological factors relevant to the Cesarean sections carried out in these pregnancies. Results: The Cesarean section rate in Australian women overall increased by an average of 0.59% annually over 20 years, from 26.0% to its calculated 2020 value of 37.3%. For the operations in women with epilepsy, the corresponding figures were 0.71% annually, and 34.4% and 48.7%. The average annual rate of increase for pre-labor operations was 0.89% to a 2020 value of 39.1%, the annual rate for operations during labor showing no statistically significant change. Multivariate regression analysis identified a number of characteristics of women with epilepsy that were statistically significantly associated with an increased likelihood of Cesarean section, but of these only seizures continuing to occur in the third trimester and having chronic illness, in particular migraine, were neurological ones. In 70 migraine-affected women, the Cesarean section rate was 51.4%, compared with 39% in the remaining pregnancies (P < 0.05). Conclusions: Having seizures in the final trimester of pregnancy and having chronic neurological illness, especially migraine, favored Cesarean section being carried out in Australian women with epilepsy, but did not adequately account for the increasing rates of occurrence of the operation over the past 20 years.",
keywords = "Cesarean section, Epilepsy, Migraine, Pregnancy, Seizures",
author = "Vajda, {F. J.E.} and O'Brien, {T. J.} and Graham, {J. E.} and Hitchcock, {A. A.} and P. Perucca and R. Kuhn and Lander, {C. M.} and Eadie, {M. J.}",
note = "Funding Information: P. Perucca is supported by an Early Career Fellowship from the National Health and Medical Research Council (APP1163708), the Epilepsy Foundation, the Royal Australasian College of Physicians, The University of Melbourne, Monash University, the Weary Dunlop Medical Research Foundation, Brain Australia, and the Norman Beischer Medical Research Foundation. He has received speaker honoraria or consultancy fees to his institution from Chiesi, Eisai, LivaNova, Novartis, Sun Pharma, Supernus, and UCB Pharma, outside the submitted work. He is an Associate Editor for Epilepsia Open. Funding Information: T. O{\textquoteright}Brien has received research support from the Epilepsy Society of Australia, NHMRC, RMH Neuroscience Foundation, Sanofi-Aventis, UCB Pharma, and Sci-Gen and Eisai. Funding Information: We are grateful to professional and lay colleagues and bodies for referring patients to the APR, and to the Scientific Advisory Board and the Ethical Research Committees of St. Vincent's Hospital, Monash Medical Centre, the Royal Melbourne Hospital and other institutions for continuing ethics oversight of the APR. Over its years, The Epilepsy Society of Australia, The Royal Melbourne Hospital Neuroscience Foundation, Epilepsy Australia, the NHMRC and the pharmaceutical companies Sanofi-Aventis, UCB Pharma, Janssen-Cilag, Novartis, Sci-Gen, Eisai and Genzyme have provided financial support toward maintaining the APR at various stages of its existence. Publisher Copyright: {\textcopyright} 2022 Elsevier Inc.",
year = "2022",
month = jul,
doi = "10.1016/j.yebeh.2022.108740",
language = "English",
volume = "132",
journal = "Epilepsy & Behavior",
issn = "1525-5050",
publisher = "Academic Press",
}