Pregnant or want to get pregnant with epilepsy?

(ARA) – Mary Katherine Albritton had a normal childhood despite being diagnosed with epilepsy when she was six years old. Her parents worked to teach her about her condition, and she grew up to be a happy adult. But in 2005 she got a surprise, she was pregnant. As an adult with epilepsy, she wondered about the risks to her and her fetus.

“I had six seizures through my pregnancy, but my daughter Taylor was born a healthy, beautiful baby,” says Albritton, who worked closely with her neurologist throughout the course of her pregnancy.

Albritton is just one of a surprisingly large number of women with epilepsy who have had successful childbirths. It is estimated that about half a million women with epilepsy in the United States are of childbearing age and that three to five out of every 1,000 births are to women with epilepsy. The majority of people with epilepsy have well-controlled seizures, are otherwise healthy, and expect to participate fully in life experiences, including pregnancy.

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 valproate, an epilepsy drug that can cause birth defects.

“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,” says lead guideline author Dr. Cynthia Harden, 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 that, 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,” says Harden. “These guidelines show that women with epilepsy are not at a substantially increased risk of having a Caesarean 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.”

When Albritton had her second child, Thomas, she had three seizures during her pregnancy. “June 15, 2007 was my last seizure when I was pregnant with Thomas. He was born a healthy baby boy on November 5. When people say their kids are miracles, mine really are. I haven’t had a seizure since.”

Her advice for other women with epilepsy who want children: “Understand that epileptic women are capable of having healthy babies. I suggest staying in close contact with your obstetrician and urologist.”

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