Long-term seizure recurrence after eclampsia: A systematic review and meta-analysis

Int J Gynaecol Obstet. 2020 Nov;151(2):175-179. doi: 10.1002/ijgo.13347. Epub 2020 Sep 16.

Abstract

Background: Seizure recurrence after a fit has implications for both individuals and healthcare providers guiding neurologic prognosis, treatment, and driving and work restrictions. A systematic review of long-term seizure recurrence after eclampsia will help to quantify recurrence risk in this setting.

Objective: To evaluate the long-term recurrence of seizures after eclampsia.

Search strategy: After PROSPERO registration, Medline (Ovid), Embase, and Cochrane Library were searched by using the terms (eclampsia OR eclamp* OR eclamptic seizure* OR eclamptic fit*) AND (recur* OR recurrent fit* OR recurrent seizure*) for studies published up until December 2019.

Selection criteria: Studies describing long-term seizure recurrence after a diagnosis of eclampsia were included.

Data collection and analysis: Data were extracted from studies independently by two authors. Pooled prevalence was calculated and weighted based on sample size with a 95% confidence interval (CI).

Main results: Initially, 1754 unique studies were identified and 4 were included in the final analysis. The studies involved 1896 women, of whom 7 (0.37%) were affected by a further seizure. The weighted pooled prevalence of seizure recurrence was 0.18% (95% CI, 0.03-1.02).

Conclusion: The absolute rate of long-term seizure recurrence after eclampsia is extremely low and within safe limits for driving.

Keywords: Eclampsia; Recurrence risk; Seizures.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adult
  • Eclampsia*
  • Female
  • Humans
  • Longitudinal Studies
  • Pregnancy
  • Prenatal Care
  • Recurrence
  • Risk Factors
  • Seizures / epidemiology*
  • Seizures / etiology
  • Time Factors