Pregnancy raises special concerns for women taking antiseizure medications. If you are planning on starting a family, talk to your doctor before you become pregnant to review the medication you are currently taking. Also talk to your doctor about folic acid supplementation.
Most women with epilepsy give birth to normal, healthy infants. There are, however, some special considerations related to pregnancy for women with epilepsy.
It is important that you do not stop taking antiseizure medication without medical advice. Uncontrolled seizures can pose a serious risk to you and your unborn baby.
- All women have a 2 to 3 per cent risk of having a child with a birth defect
- More than 90 per cent of women with epilepsy give birth to normal, healthy infants
- For women with epilepsy, the risk of having a child with a birth defect is about 4 to 6 per cent, but some medications (such as valproate) are associated with a higher risk
- Taking folic acid before and during pregnancy may decrease the risk of some birth defects and is recommended for all women of child-bearing age
- Pregnancy changes the way medications are processed in the body, so regular checks and possible adjustments to dosage may be required
- The frequency of seizures may change during pregnancy
Topics to discuss with your healthcare provider:Expand Topics to discuss with your healthcare provider: Section
Discussion Checklist: click here for a helpful checklist from epilepsy.com that you can take to your healthcare appointments
Share the following provincial guidelines with your healthcare provider:
PROVINCIAL GUIDELINES FOR THE MANAGEMENT OF EPILEPSY IN ADULTS AND CHILDREN. Section VI (pages 31-32) of this Ontario guideline document has specific information related to women with epielpsy with a special focus on pregnancy.
Is your antiseizure medication safe during pregnancy?Expand Is your antiseizure medication safe during pregnancy? Section
Obtaining the best seizure control possible with the fewest number of medications is a key goal.
For planned pregnancies – speak with your healthcare provider about your treatment before you become pregnant.
For unplanned pregnancies – contact your healthcare provider as soon as find out that you are pregnant. Continue to take your antiseizure medication. Do not make any changes in your treatment without medical advice.
Some questions to ask your healthcare provider about your antiseizure medication are:
- What information is known about the safety of my medication when taken during pregnancy?
- Are there any risks to my baby? How do these risks compare to risks in the general population?
- What can be done to optimize my safety and the safety of my child?
- What other antiseizure medications or treatment options could be used for my type of epilepsy?
Uncontrolled seizures could also increase the risk to your health as well as to the health of a developing baby, so this is important to keep in mind as well.
Do you take Epival (divalproex sodium) or Depakene (valproic acid)?Expand Do you take Epival (divalproex sodium) or Depakene (valproic acid)? Section
These drugs can have affects on a developing baby. It is important to speak with your healthcare provider to discuss the treatment options available to control your seizures.
Children exposed to valproate (e.g. Epival and Depakene) during pregnancy have a 10% risk of a birth defect and a 30-40% risk of a developmental disorder.
There is a Patient Guide about these drugs. This booklet is part of a toolkit that has been launched in the United Kingdom to ensure that female patients are better informed about the risks of taking valproate during pregnancy.
If you are thinking about becoming pregnant or are pregnant, do not stop taking valproate (e.g. Epival or Depakene) until you have discussed this with your doctor. Stopping an antiseizure drug without medical supervision can be dangerous for you and your baby.
Other resourcesExpand Other resources Section
- visit the NORTH AMERICAN AED PREGNANCY REGISTRY
- visit the MATERNAL OUTCOMES and NEURODEVELOPMENTAL EFFECTS OF ANTIEPILEPTIC DRUGS (MONEAD) website
- download this information sheet published by The American Academy of Neurology WOMEN WITH EPILEPSY: DRUG RISKS AND SAFETY DURING PREGNANCY
- Share these Ontario guidelines with your healthcare provider
PROVINCIAL GUIDELINES FOR THE MANAGEMENT OF EPILEPSY IN ADULTS AND CHILDREN
- contact MotherRisk
416-813-6780 (Toronto and GTA)
- if you take Epival (divalproex sodium) or Depakene (valproic acid), download this PATIENT GUIDE on valproate and share this GUIDE for HEALTHCARE PROVIDERS with your doctor
- the following information sheet from the American Academy of Neurology has information about Tegretol (carbamazepine), Lamictal (lamotrigine), phenobarbital, Dilantin (phenytoin), Epival (divalproex sodium) and Depakene (valproic acid) WOMEN WITH EPILEPSY: DRUG RISKS TO THE FETUS OR BABY DURING PREGNANCY