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dc.contributor.authorLeinonen, Maarit K.
dc.contributor.authorIgland, Jannicke
dc.contributor.authorDreier, Julie Werenberg
dc.contributor.authorAlvestad, Silje
dc.contributor.authorCohen, Jacqueline Mallory
dc.contributor.authorGilhus, Nils Erik
dc.contributor.authorGissler, Mika
dc.contributor.authorSun, Yuelian
dc.contributor.authorTomson, Torbjörn
dc.contributor.authorZoega, Helga
dc.contributor.authorVegrim, Håkon Magne
dc.contributor.authorChristensen, Jakob
dc.contributor.authorBjørk, Marte-Helene
dc.date.accessioned2024-09-23T12:47:25Z
dc.date.available2024-09-23T12:47:25Z
dc.date.created2024-06-18T11:06:01Z
dc.date.issued2024
dc.identifier.issn0013-9580
dc.identifier.urihttps://hdl.handle.net/11250/3153786
dc.description.abstractObjective Research points to disparities in disease burden and access to medical care in epilepsy. We studied the association between socioeconomic status (SES) and antiseizure medication (ASM) use in pregnancies with maternal epilepsy. Methods We conducted a cross-sectional study consisting of 21 130 pregnancies with maternal epilepsy identified from Nordic registers during 2006–2017. SES indicators included cohabitation status, migrant background, educational attainment, and household income. Main outcomes were the proportion and patterns of ASM use from 90 days before pregnancy to birth. We applied multiple imputation to handle SES variables with 2%–4% missingness. We estimated adjusted risk ratios (aRRs) and 95% confidence intervals (CIs) using modified Poisson regression with the highest SES category as reference. Results Mothers with the highest education and the highest income quintile used ASMs least frequently (56% and 53%, respectively). We observed increased risks of ASM discontinuation prior to or during the first trimester for low SES. The risk estimates varied depending on the SES indicator from aRR = 1.27 for low income (95% CI: 1.03–1.57) to aRR = 1.66 for low education (95% CI: 1.30–2.13). Migrant background was associated with ASM initiation after the first trimester (aRR 2.17; 95% CI 1.88–2.52). Low education was associated with the use of valproate during pregnancy in monotherapy (aRR 1.70; 95% CI 1.29–2.24) and in polytherapy (aRR 2.65; 95% CI 1.66–4.21). Low education was also associated with a 37% to 39% increased risk of switching from one ASM to another depending on the ASM used. For the other SES indicators, aRRs of switching varied from 1.16 (foreign origin; 95% CI 1.08–1.26) to 1.26 (not married or cohabiting; 95% CI 1.17–1.36). Significance Low SES was associated with riskier patterns of ASM use: discontinuation, late initiation, and switching during pregnancy. These findings may reflect unplanned pregnancies, disparities in access to preconception counseling, and suboptimal care.en_US
dc.language.isoengen_US
dc.publisherWileyen_US
dc.rightsNavngivelse-Ikkekommersiell 4.0 Internasjonal*
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/deed.no*
dc.titleSocioeconomic differences in use of antiseizure medication in pregnancies with maternal epilepsy: A population-based study from Nordic universal health care systemsen_US
dc.typeJournal articleen_US
dc.typePeer revieweden_US
dc.description.versionpublishedVersionen_US
dc.rights.holderCopyright 2024 The Author(s)en_US
cristin.ispublishedtrue
cristin.fulltextoriginal
cristin.qualitycode1
dc.identifier.doi10.1111/epi.18022
dc.identifier.cristin2277044
dc.source.journalEpilepsiaen_US
dc.source.pagenumber2397-2411en_US
dc.relation.projectNorges forskningsråd: 273366en_US
dc.relation.projectNorges forskningsråd: 328615en_US
dc.relation.projectNordforsk: 83539en_US
dc.relation.projectNorges forskningsråd: 262700en_US
dc.relation.projectNordforsk: 83796en_US
dc.identifier.citationEpilepsia. 2024, 65 (8), 2397-2411.en_US
dc.source.volume65en_US
dc.source.issue8en_US


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Navngivelse-Ikkekommersiell 4.0 Internasjonal
Except where otherwise noted, this item's license is described as Navngivelse-Ikkekommersiell 4.0 Internasjonal