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Most women who have epilepsy
deliver healthy babies. But the risk of birth defects, stillbirth, and seizure-related
problems is higher for babies born to women with epilepsy. Most antiepileptic medicines
increase the risk even more.
If you have epilepsy and become pregnant, stopping medicine
treatment is not always the best solution. Having seizures during pregnancy can
also harm the baby. And pregnancy causes changes in your body that may increase
the frequency of seizures.
The following information is based on guidelines from the American
Academy of Neurology.1, 2
Before you become pregnant, talk with your doctor
about your epilepsy treatment. Seizures or seizure medicine may cause damage to
the baby very early in your pregnancy, before you even know that you are
pregnant. Your doctor will help you consider whether potential seizures or
continued use of antiepileptic medicine poses the greater risk to your baby.
In general, the recommendation is to only use one medicine for epilepsy and to use it at the lowest possible dose to avoid potential problems from the medicine. Medicines may not harm a baby as much as the pregnant woman having seizures may.
If you are not yet pregnant but are planning to become pregnant,
stopping medicine might be an option if you have been seizure-free for several
years. Your doctor may suggest a trial run without the medicine before you
become pregnant. Experts recommend that this trial run take place at least 6
months before the pregnancy so that you and your doctor can see the results of
stopping your treatment. If you begin having seizures, you may need to go back
If you need to stay on medicine during your pregnancy, your doctor may suggest some changes in your treatment that reduce the risk of birth
defects. These changes may include:
You may put yourself and your
baby at greater risk if you change, reduce, or stop taking your medicine while you are
pregnant. Talk with your doctor first.
If you have epilepsy and find out that you are pregnant, consult your
doctor immediately. Do not stop taking your medicine without first talking to
Harden CL, et al. (2009). Practice parameter update: Management issues for women with epilepsy—Focus on pregnancy (an evidence-based review): Teratogenesis and perinatal outcomes: Report of the Quality Standards Subcommittee and Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology, 73(2): 133–141.
Harden CL, et al. (2009). Practice parameter update: Management issues for women with epilepsy—Focus on pregnancy (an evidence-based review): Vitamin K, folic acid, blood levels, and breastfeeding: Report of the Quality Standards Subcommittee and Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and American Epilepsy Society. Neurology, 73(2): 142–149.
August 28, 2013
John Pope, MD - Pediatrics & Steven C. Schachter, MD - Neurology
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