New Guidelines Released on Epilepsy and Pregnancy

The American Academy of Neurology and the American Epilepsy Society have released new guidelines about pregnancy in women with epilepsy. Published in the April 28, 2009 issue of the journal Neurology, the guidelines provide clinicians with several recommendations that can help decrease the risk of a complicated pregnancy.

The guidelines caution pregnant women with epilepsy against taking the antiepileptic drug valproate because it may cause fetal malformations and impaired cognitive function in children of women who take the drug while pregnant. However, the Epilepsy Foundation stresses the importance of consulting your health care provider before stopping any medication. It is potentially dangerous to stop taking any antiepileptic drug abruptly.

The guidelines suggest that:

• Whenever possible, women with epilepsy should not take more than one antiepileptic drug at a time during pregnancy because taking more than one drug may increase the risk of birth defects compared to taking only one medication.

• Pregnant women with epilepsy should have blood tests for antiepileptic drug levels on a regular basis. Levels of antiepileptic medications may decrease in the course of the pregnancy and regular testing will help detect when doses of the medication should be adjusted.

• Women with epilepsy who smoke could experience an increased risk of complications during pregnancy.

• Whenever possible, doctors should avoid prescribing phenytoin and phenobarbital to women of childbearing age with epilepsy in an effort to lower the chance of cognitive problems in children. Women of childbearing age taking these medications should consult their doctor before making any changes to their medication regimen.

“Overall, what we found should be very reassuring to every woman with epilepsy planning to become pregnant,” said Cynthia L. Harden, M.D., director of the epilepsy Division at the University of Miami’s Miller School of Medicine and member of the American Academy of Neurology. “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.”

Click here to view the AAN Guideline Summaries

For the full Guidelines, click here:

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