Epilepsy is a neurological disorder that causes unpredictable, unprovoked, and recurrent seizures, which occur due to sudden, uncontrolled electrical disturbances in the brain, leading to changes in behaviour and movements. It can occur in anyone, regardless of age and gender, even pregnant women.
According to a study published in the International Journal of Molecular Sciences (IJMS), an estimated six crore people worldwide suffer from epilepsy, half of whom are women, and about one-third of them are of childbearing age.
In this article, with the helpful insights of Dr Kavita Barhate, Consultant-Neurology, SRV Hospitals, Dombivili, we will try to unravel the impact of epilepsy on pregnant women and understand whether taking antiepileptic medications is safe.
Also Read: Epilepsy Has Several Types, How Are These Diagnosed? Doctor Answers
How Epilepsy Affects Women During Pregnancy
Dr Barhate said, “Women with epilepsy need to take extra precaution during pregnancy as hormonal changes due to pregnancy can influence seizure threshold. Some may experience lesser episodes whereas others may have increased seizures.”
The study published in IJMS suggested that most women with epilepsy do not have seizures during pregnancy, whereas a third of them may experience an increase in the number of epileptic seizures during this period.
“The first-ever epileptic seizure can occur at any time during pregnancy. These may be symptomatic seizures occurring as a result of metabolic disorders, low blood pressure, eclampsia, and other conditions coinciding with pregnancy such as central nervous system (CNS) infections or strokes,” the study added.
According to Dr Barhate, seizures may pose risks of injury due to falls, aspiration or accidents to the mother. It also affects maternal health due to the stress and anxiety associated with managing epilepsy during pregnancy.
Discussing the impact of seizures on the foetus, the doctor shares, “There can be a reduction in oxygen supply to the foetus, possibly leading to foetal distress. In severe cases, there is a risk of preterm birth, low birth weight babies born to mothers suffering from epilepsy.”
Is It Safe To Take Anti-Epileptic Medications During Pregnancy?
When women experience uncontrollable seizures during pregnancy, it holds the risk of harming both the mother and the child, which is why it becomes very important to balance the risks of medication and manage epilepsy during pregnancy, said Dr Barhate.
As per him, AEDs have been associated with an increased risk of birth defects when taken during pregnancy. Therefore, the safety of taking anti-seizure medications during pregnancy is a complex issue and depends on various factors, including the specific medication, dosage, and individual health circumstances.
Also Read: Epileptic Fit: Here Are Its Signs, Causes, Diagnosis And Treatment
The doctor emphasised on close monitoring and collaboration between neurologists and obstetricians to ensure comprehensive prenatal care for women with epilepsy.
He added, “Many newer antiepileptic drugs are deemed safer during pregnancy as compared to the older antiepileptic drugs,” adding that the best time to change over to a safer antiepileptic drug is before conception.”
How To Minimise The Harmful Effects Of Pregnancy
To minimise and prevent the harmful effects of epilepsy during pregnancy, Dr Barhate shared a few strategies:
- Discuss with your neurologist and obstetrician before planning pregnancy; they can guide you through the pregnancy and make you aware of the impact of antiepileptic medications
- Folic acid supplements should be started before conception and throughout the pregnancy to reduce risk of certain birth defects
- Regular monitoring and check-ups should be scheduled with your doctor
- Maintain a healthy lifestyle
- Adequate sleep
The doctor also advised to keep a detailed seizure diary to track frequency and triggers, while building a strong support system, including family and friends.