Differences in Delivery Type, Breastfeeding Initiation, and Length of Postpartum Hospitalization in Patients with Epilepsy within a Single Hospital System
Kelly Rios1, Anumeha Sheth2, Sarah Lindsay3
1University of Connecticut School of Medicine, 2Hartford Healthcare, 3Hartford Healthcare Medical Group
Objective:

The objective of this study was to assess whether differences exist in delivery types and obstetric outcomes in patients with epilepsy (PWE) versus patients without epilepsy (PWoE) in a diverse hospital system.

Background:

PWE account for 0.3% to 0.5% of all births annually. PWE have higher obstetric healthcare utilization and lower rates of breastfeeding initiation, while data on cesarean delivery rates is mixed. However, much of this data is limited to largely white and non-Hispanic populations.

Design/Methods:

This, retrospective, observational study compared obstetric and delivery outcomes between PWE and PWoE using electronic medical record data from 09/01/2018 to 05/31/2023 in a single multihospital system. Outcomes were compared using Chi-square, Fisher’s Exact, or Mann-Whitney U tests. Following the preliminary study of categorical information with a p<0.05, post-hoc tests with Bonferroni adjustments were conducted. 

Results:

Compared with PwoE (n=33,575), PWE (n=199) were more likely to undergo labor induction (44.2% vs. 37.4%; p=0.049), have preterm deliveries (14.1% vs. 8.1%; p=0.002), have longer (≥3 day) postpartum hospitalizations (32.8% vs. 24.8%; p=0.009), have substance use disorder(s) (5.0% vs. 0.8%; p<0.001) and were less likely to initiate breastfeeding (82.2% vs. 89.9%; p=0.001). A higher proportion of PWoE were non-English speakers (8.7% vs. 2.5%; p=0.002) and never smoked (78.2% vs. 60.3%; p<0.001) compared to PWE. Though a higher proportion of PWE delivered neonates requiring intensive care (9.0% vs. 5.7%; p=0.063) and had cesarean deliveries (37.2% vs. 31.5%; p=0.084), the difference compared to PWoE was not statistically significant. The percentage of Hispanic or Latinx-identifying patients in our sample was higher than the national average (26.9% vs. 19.1%).

Conclusions:

These findings support existing literature on breastfeeding, obstetrical healthcare utilization, and preterm deliveries in a sample of PWE with greater Hispanic or Latinx representation.  

10.1212/WNL.0000000000205376