Effect of epilepsy in pregnancy on fetal growth restriction: a systematic review and meta-analysis

Epilepsy is one of the most common neurological diseases during pregnancy. However, the influence of epilepsy on fetal growth is not understood. Thus, this study conducted a meta-analysis to determine the influence of epilepsy during pregnancy on fetal growth restriction (FGR). BIOSIS, Medline, Embase, and PubMed databases were searched between January 2000 and January 2016. Without imposing language or regional restrictions, referenced articles were selected. Final analysis included 684 citations from 11 studies. Estimated risk of FGR was 1.28-fold higher in epileptic pregnant women than in non-epileptic women [95% confidence interval (95% CI) 1.09-1.50, p < 0.05]. Given the course of previous studies, hierarchical analysis of pregnant women who use antiepileptic drugs (AEDs) was conducted. Results show that FGR rate is significantly increased even if AEDs were taken [odds ratio 1.26, 95% CI 1.13-1.41, p < 0.05]. Although modest bias cannot be avoided, our meta-analysis indicated that epilepsy participates in fetal development as an unfavorable factor, and AEDs seemed to be useless in decreasing the occurrence rate of FGR.