Abstract
PurposeTo examine the association between epilepsy and frequency and time of initiation of prenatal care use among pregnant women in Finland. MethodsWe conducted a nationally representative, population-based cross-sectional study including pregnant women with epilepsy in Finland between 2000-2014. Selected demographic and clinical data were obtained by linking multiple national health registers and census. Crude and adjusted odds ratios (aOR) and 95% confidence intervals (CI) were estimated using logistic regression analysis. Effect modification of the main association was examined by parity. ResultsWe examined 10,798 and 921,873 women with and without epilepsy, respectively, and the two groups differed significantly on prenatal care constructs. Women with epilepsy were more likely to have 25 or more total prenatal visits (10.4 % vs. 5.8%) and earlier initiation of prenatal care (at <8 weeks of gestation) (30.8% vs. 24.7%) compared to women without epilepsy. Epilepsy was significantly associated with 25 or more prenatal care visits (aOR=1.84; 95% CI=1.71, 1.98). The association between epilepsy and early initiation of prenatal care (<8 weeks) was significantly modified by parity, where multiparous women had increased odds of early prenatal care initiation (aOR=1.32; 95% CI=1.24, 1.41) compared to nulliparous women (aOR=1.19; 95% CI=1.11, 1.28). ConclusionsFinnish healthcare, which is publicly funded and freely accessible, provided pregnant women with epilepsy adequate and timely prenatal care. Parity modified the period when prenatal care was initiated as multiparous women were initiated early to receive prenatal care compared to nulliparous women.
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