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[Epilepsy and pregnancy].

L Schäffler1

  • 1Neurologische Universitätsklinik, Inselspital Bern.

Schweizerische Medizinische Wochenschrift
|October 13, 1990
PubMed
Summary
This summary is machine-generated.

Pregnancy outcomes for women with epilepsy are unpredictable, with varying seizure control and increased risks for congenital malformations. Antiepileptic drug levels may drop, and valproate should be avoided during pregnancy.

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Area of Science:

  • Obstetrics and Gynecology
  • Neurology
  • Pharmacology

Context:

  • Epilepsy affects approximately 1% of pregnant women globally.
  • Pregnancy's impact on epilepsy is highly individualized, affecting seizure frequency unpredictably.
  • Maternal epilepsy is associated with a 1.5-3 times higher risk of congenital anomalies in offspring.

Purpose:

  • To review the effects of pregnancy on epilepsy and vice versa.
  • To discuss challenges in managing antiepileptic drug (AED) therapy during pregnancy.
  • To highlight risks and provide guidance for pregnant women with epilepsy.

Summary:

  • Seizure frequency during pregnancy varies: no change in 33-50%, increase in 25-33%, and improvement in 25-33% of cases.
  • Plasma concentrations of AEDs often decrease during pregnancy, necessitating dose adjustments.

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  • Perinatal mortality is doubled, and congenital malformation risks are elevated, influenced by AEDs, genetics, epilepsy type, and seizure severity.

    • Impact:

    • Valproate use in pregnant women is strongly discouraged due to increased neural tube defect incidence.
    • Current evidence does not contraindicate breastfeeding for mothers on AED therapy.
    • Improved understanding can guide clinical management, optimizing outcomes for pregnant women with epilepsy and their infants.