Generalized and focal epilepsy and pregnancy, delivery and neonatal outcomes: a retrospective cohort study
Bibliographic record
Abstract
We previously demonstrated associations between maternal epilepsy and pregnancy outcomes. Now, we seek to determine whether these outcomes differ between generalized and focal epilepsy. A retrospective cohort study was completed using the HCUP-NIS database. Pregnancy outcomes were compared across generalized and focal epilepsy types, as determined via ICD-9 codes. Of 2,596 pregnancies, 1978 women had focal epilepsy and 618 had generalized epilepsy. Focal epilepsy was associated with increased rates of cesarean sections as compared to generalized epilepsy (aOR = 1.27;95 %CI = 1.02-1.57;p = 0.030). Other pregnancy outcomes did not differ significantly, including pregnancy induced hypertension, gestational hypertension, preeclampsia, eclampsia, preeclampsia and eclampsia superimposed on pre-existing hypertension, gestational diabetes mellitus, placenta previa, preterm premature rupture of membranes, preterm delivery, abruptio placenta, chorioamnionitis, operative vaginal delivery, hysterectomy, postpartum hemorrhage, wound complications, maternal death, transfusion, maternal infection, deep venous thrombosis, pulmonary embolism, venous thromboembolism, disseminated intravascular coagulation, small for gestational age, intrauterine fetal demise and congenital anomalies (P > 0.05, all). As compared to generalized epilepsy, focal epilepsy was associated with younger age (p < 0.001), lower income quartile (p = 0.013), tobacco smoking during pregnancy (p = 0.037) and illicit drug use (p < 0.001). Women with focal epilepsy were more likely than those with generalized epilepsy to be covered by Medicaid and less likely to be covered through Medicare or private insurance (p < 0.001). No significant differences were observed regarding other maternal characteristics. Women with focal epilepsy are at a higher risk of delivery through cesarean section than those with generalized epilepsy. The reason why remains unclear. Reassuringly, other pregnancy complications are not increased by generalized as opposed to focal epilepsy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".