| アブストラクト | OBJECTIVES: To examine the prevalence of the maternal postnatal six-week check (SWC) in women with epilepsy compared to a sample of the postnatal population without epilepsy, and assess whether the SWC is associated with health outcomes in the first year postpartum. METHODS: Clinical Practice Research Datalink Aurum and Hospital Episode Statistics data were used to identify births between January1998-March2020 to women with epilepsy (n = 23,533) and a random sample of births to women without epilepsy (n = 317,369). The adjusted risk ratio (aRR) for not having a SWC in women with compared to without epilepsy was estimated using modified Poisson regression. The association between receiving a SWC and postpartum health outcomes was assessed using Cox regression. RESULTS: The likelihood of not having a SWC did not differ between those with and without epilepsy (42.7% vs 43.4%, aRR = 1.01, 95%CI = 0.99-1.03). Among all women, not having a SWC was associated with a lower subsequent likelihood of being prescribed prophylactic (aHR = 0.59, 95%CI = 0.58-0.60) and emergency (aHR = 0.95, 95%CI = 0.91-0.99) contraception and having urinary and/or faecal incontinence (aHR = 0.67, 95%CI = 0.61-0.73) or dyspareunia, perineal and/or pelvic pain (aHR = 0.70, 95%CI = 0.65-0.75) recorded in the year postpartum, with no evidence these associations differed according to whether a woman had epilepsy. Not having a SWC was also associated with a lower likelihood of having depression and/or anxiety recorded in the first year postpartum among those without (aHR = 0.86, 95%CI = 0.84-0.89) but not with epilepsy (aHR = 1.01, 95%CI = 0.93-1.09). The SWC was not associated with epilepsy relevant outcomes (Accident and emergency visits or unplanned hospital admission for epilepsy, mortality). CONCLUSIONS: Around 2 in every 5 women had no evidence of a maternal SWC, with no evidence epileptic women had a different prevalence to the general postnatal population. The maternal SWC may play a role in increasing the use of contraception and the detection or treatment of adverse health outcomes in the first year postpartum. |
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| 投稿者 | Fitzpatrick, Kathryn E; Bowen, Liza; Li, Yangmei; Kwok, Chun Hei; Alderdice, Fiona; Dealmeida, Suresha; Gale, Chris; Kenyon, Sara; Quigley, Maria A; Sanders, Julia; Siassakos, Dimitrios; Carson, Claire |
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| 組織名 | NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National;Perinatal Epidemiology Unit, Nuffield Department of Population Health, University;of Oxford, Oxford, United Kingdom.;Population Health Research Institute, St George's, University of London, London,;United Kingdom.;Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Old;Road Campus, University of Oxford, Oxford, United Kingdom.;Applied Health Research Unit, Nuffield Department of Population Health,;University of Oxford, Oxford, United Kingdom.;School of Nursing and Midwifery, Queen's University Belfast, Belfast, United;Kingdom.;Bolingbroke Medical Centre, Battersea, London, United Kingdom.;Neonatal Medicine, School of Public Health, Faculty of Medicine, Chelsea and;Westminster Hospital campus, Imperial College London, London, United Kingdom.;Centre for Paediatrics and Child Health, Imperial College London, London, United;School of Health Sciences, College of Medical and Dental Sciences, University of;Birmingham, Birmingham, United Kingdom.;School of Healthcare Sciences, Cardiff University, Cardiff, United Kingdom.;Institute for Women's Health, University College London, London, United Kingdom.;University College London Hospitals NIHR Biomedical Research Centre, London, |
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