Epilepsy and pregnancy

Abstract

There are currently about 15 million women of childbearing age worldwide who suffer from epilepsy. Overall, 0.3–0.4% of newborns are born to mothers with epilepsy, and almost half of these women experience recurrent seizures. The article discusses issues related to pregnancy planning, the prognostic impact of seizure frequency, type and course of epilepsy on pregnancy outcomes, and potential risks associated with this condition. Summarized data from the latest recommendations for correction of therapy and data on changes in the pharmacokinetics of antiepileptic drugs during pregnancy are presented. A classification of antiepileptic drugs according to their teratogenic potential and their effect on the development and behaviour of the child is presented. Various approaches to pregnancy management are discussed. In addition, scenarios for pregnancy management in poorly controlled epilepsy and status epilepticus are discussed as well as adjustment of therapy in the postpartum period and measures for the safe care of newborns.

Keywords

• epilepsy
• pregnancy
• pregnancy planning
• pregnancy management
• anticonvulsants
• postpartum period
• teratogenesis
• major congenital malformations