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Poster Session 1

Category: Medical/Surgical/Diseases/Complications

Poster Session 1

(229) Evaluation of Severe Maternal Morbidity in Pregnancies Complicated by Maternal Seizure Disorder

Wednesday, February 11, 2026

10:30 AM - 12:00 PM

Submitting Author and Presenting Author(s)

Janki Patel, DO

Resident Physician
Advocate
Chicago, Illinois, United States

Coauthor(s)

Stephanie Schreiber-Gonzalez, DO (she/her/hers)

Ascension Healthcare
Clarendon Hills, Illinois, United States
Rachel K. Harrison, MD (she/her/hers)

Clinical Professor Maternal-Fetal Medicine
Department of Maternal-Fetal Medicine, Advocate Aurora Health
Chicago, Illinois, United States
CH

Calla Holmgren, MD

Physician
Advocate Medical Group
Chicago, Illinois, United States

Objective:
To identify prevalence of seizure disorders in pregnancy in a modern cohort and assess rates of severe maternal morbidity (SMM) among those with seizure disorders.

Study Design:
Retrospective cohort study using the National Inpatient Sample (NIS) database from 2017-2021 through HCUP/AHRQ encompassing antepartum, delivery and postpartum admissions. Pregnant patients with seizure disorder were identified by ICD-10 codes for epilepsy and were compared to pregnant patients without. We assessed prevalence of seizure disorders in pregnancy from 2017 to 2021 using weighted sampling. We compared baseline characteristics of those who experienced seizures to those who did not. Our primary outcome was a composite of SMM as per the 21 indicators defined by the CDC. Secondary outcomes were hemorrhage, cesarean delivery, maternal death, and maternal length of stay. Statistical analysis was performed using Stata version 17.0 via student’s T test, Chi2 analysis, and linear and logistic regression to control for confounders.

Results:
Over a 5-year period, more than 16 million subjects were included of which a total of 835,443 pregnant patients had a seizure disorder. The incidence of epilepsy increased from 2017 to 2021 (0.184% to 0.210%, p < 0.001). Patients with a seizure disorder were more likely to be overweight, use tobacco and have diabetes mellitus and hypertension. They were more likely to experience the composite SMM, hemorrhage, cesarean delivery, and maternal death with longer length of stay than those without a seizure disorder. These findings persisted in the adjusted analysis with rates of SMM and maternal death much more likely among those with seizure disorder (aOR 2.05, 95% CI 1.92-2.18 and aOR 5.94, 95% CI 2.89-12.24, respectively). Hemorrhage, cesarean, and increased length of stay also remained associated.

Conclusion:
Seizure disorder in pregnancy increased in frequency from 2017 to 2021 and is associated with identifiable risk factors including obesity, tobacco use, DM and hypertension. These patients are more likely to experience SMM and death than pregnant patients without a seizure disorder.