Epilepsy Awareness Program - Epilepsy and Pregnancy
Most pregnant women with epilepsy have a normal pregnancy and childbirth.
For women with epilepsy, the risk of complications during pregnancy and labour is slightly higher than for women without epilepsy. The small increase in risk is due to the small risk of harm coming to a baby if you have a serious seizure whilst pregnant, and also the small risk of harm to an unborn baby from antiepilepsy medicines.
You may note that the risk of complications to your unborn baby is greater with a seizure compared to the risk of not taking your epilepsy medication.
Preconceptional counseling and coordination of care among all members of the health care team is key to treating women with epilepsy of reproductive age.
The most important thing you should know is that most women with epilepsy who have children give birth to normal, healthy babies. In fact, your chances of having a healthy child are greater than 90%. Experts say that you shouldn't let the fact that you have epilepsy discourage you from trying to have a family.
There are increased risks, but these risks can be minimized by working carefully with your doctor.
Years ago, women who had epilepsy were often discouraged from getting pregnant. Today, that's no longer the case. In the other hand, women with epilepsy have fewer children than women in general.
Research has indicated that women with epilepsy have a higher incidence of menstrual irregularities, polycystic ovarian disease and reproductive endocrine disorders. Any of these may cause a reduce in fertility.
Before becoming pregnant
Women with epilepsy who are thinking of having children need to know about the genetics of epilepsy; the effects of pregnancy on the medical management of seizures; the effects of seizures and medication on the developing fetus; and the planned management of seizures during labour and after birth.
Women with epilepsy taking certain anti-epileptic drugs (AEDs) may experience failure of hormonal birth control methods. Some of the medications may lower concentrations of estrogen, thus reducing effectiveness of the hormonal contraceptive.
Does epilepsy make it more difficult to conceive?
Some women who have epilepsy have menstrual irregularities and other gynecological problems that may make it harder to conceive. Medication may be an issue as well. Some drugs used to treat seizures may contribute to infertility.
Breastfeeding for most women taking antiepilepsy medicines is generally safe.
For further details and information, you may contact your doctor.
What are the risks that your child will also have epilepsy?
In general, the probability is low that a child born to a parent with epilepsy will also have epilepsy. However, it can partly depend on your family history, as some types of epilepsy run in families. Therefore, genetic counselling may be an option to consider if you or your partner has epilepsy and also a family history of epilepsy.
Specific problems affecting infants
Babies born to mothers with epilepsy face a host of specific problems such as: Malformation, Development delay, Hereditary epilepsy, Infant mortality, Neonatal internal hemorrhaging, Low birth weight.
There is no increased risk of early fetal death (the not uncommon, spontaneous abortion within the first 20 weeks post-conception) in women with epilepsy. Late fetal loss (a stillbirth or spontaneous abortion after 20 weeks of pregnancy) shows an increased incidence in women with epilepsy.
• Epilepsy, Clinical Knowledge Summaries (June 2009)
• Bromley RL, Baker GA, Meador KJ; Cognitive abilities and behaviour of children exposed to antiepileptic drugs in utero. Curr Opin Neurol. 2009 Apr;22(2):162-6. [abstract]
• No authors listed; Intrauterine devices: an effective alternative to oral hormonal contraception. Prescrire Int. 2009 Jun;18(101):125- 30. [abstract]
• Walker SP, Permezel M, Berkovic SF; The management of epilepsy in pregnancy. BJOG. 2009 May;116(6):758-67. [abstract]
• Burakgazi E, Harden C, Kelly JJ; Contraception for women with epilepsy. Rev Neurol Dis. 2009 Spring;6(2):E62-7. [abstract]
• Holmes LB, Harvey EA, Coull BA, et al. The teratogenicity of anticonvulsant drugs. NEJM. 2001;344(15):1132-1138.
• Yerby M. Treatment of epilepsy during pregnancy. In: Wyllie E, ed. The Treatment of Epilepsy, Second Edition. Baltimore: Williams & Wilkins; 1996:785-798.
• Practice parameter: management issues for women with epilepsy (summary statement). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 1998;51:944-8.
• Seizure disorders in pregnancy. In: ACOG Educational Bulletin. Washington, DC: American College of Obstetricians and Gynecologists; 1996:231.
See Also: Neurophysiology Health Corner