International League Against Epilepsy: Six Ways Doctors Can Improve Reproductive Health in Women with Epilepsy

November 21, 2019

Encourage planned pregnancy

Having a planned pregnancy makes everything easier and lowers many of the risks associated with maternal epilepsy, said Page Pennell, director of research at Brigham & Women’s Hospital and professor of neurology at Harvard University. Planning allows time to find the most effective and safest anti-epileptic drug (AED) — one that reduces or eliminates seizures while also minimizing risks to a fetus.

Prescribe folic acid to girls and women of childbearing age

Folic acid supplements are recommended for all pregnant women to protect against certain types of birth defects. Although folic acid has not been shown to reduce the risks of major congenital malformations in the children of mothers with epilepsy, studies have found that folic acid may reduce risks for cognitive issues and autism characteristics.

Know the risks of valproate

Valproate (valproic acid, Depakote) increases the risk of certain birth defects, including heart defects, spina bifida, cleft lip, cleft palate and others. Children born of women taking valproate during pregnancy also tend to have poorer cognitive development, and a 2013 Danish registry study of more than 655,000 births showed increased risk for autism in children born to women taking valproate during pregnancy.