New guidelines developed by the American Academy of Neurology and the American Epilepsy Society show it's relatively safe for women with epilepsy to become pregnant, but caution must be taken, including avoiding one particular epilepsy drug that can cause birth defects.
The guidelines are published in the April 27, 2009, print issue of Neurology, the medical journal of the American Academy of Neurology, and will be presented April 27, 2009, at the Academy's Annual Meeting in Seattle.
The guidelines recommend women with epilepsy avoid taking the drug valproate during pregnancy.
"Good evidence shows that valproate is linked to an increased risk for fetal malformations and decreased thinking skills in children, whether used by itself or with other medications," said lead guideline author Cynthia Harden, MD, Director of the Epilepsy Division at the University of Miami's Miller School of Medicine and member of the American Academy of Neurology.
The guidelines also suggest, if possible, women with epilepsy should not take more than one epilepsy drug at a time during pregnancy since taking more than one seizure drug has also been found to increase the risk of birth defects compared to taking only one medication.
"Overall, what we found should be very reassuring to every woman with epilepsy planning to become pregnant," said Harden. "These guidelines show that women with epilepsy are not at a substantially increased risk of having a Cesarean section, late pregnancy bleeding, or premature contractions or premature labor and delivery. Also, if a woman is seizure free nine months before she becomes pregnant, it's likely that she will not have any seizures during the pregnancy."
However, Harden says pregnant women with epilepsy should consider having their blood tested regularly. "Levels of seizure medications in the blood tend to drop during pregnancy, so checking these levels and adjusting the medication doses should help to keep the levels in the effective range and the pregnant woman seizure free."