Recommendations for pregnant women with epilepsy have changed considerably over the past few decades. Once discouraged from getting pregnant at all, women with epilepsy now have a 90 percent chance of having a normal pregnancy and a healthy baby, according to the Mayo Clinic. There are, however, potential risks during pregnancy for women with epilepsy. Many risks are related to the medications taken for epilepsy rather than to the disorder itself.
Birth Defects
Babies of mothers who take medications to prevent seizures have a higher risk of birth defects, the Epilepsy Foundation reports. The risk of serious birth defects--2 to 3 percent in the general population--rises to 6 to 8 percent in women taking anti-seizure medication and may increase in women taking more than one type of medication. The most common types of major birth defects include neural tube defects such as spina bifida, an abnormal opening in the spine, heart malformations and cranio-facial malformations such as cleft lip or cleft palate and finger and toe malformations. Some major birth defects, such as neural tube defects, occur because of low folic acid levels. Anti-seizure medications affect the way the body uses folic acid, according to the American Congress of Obstetricians and Gynecologists. Pregnant women on anti-seizure medications should take additional folic acid before and during pregnancy.
Developmental delays, small head size and mental retardation may also occur, according to the Epilepsy Foundation. The risk of minor birth defects such as wide-set eyes or a short upper lip also increases two- to three-fold, to 15 percent in mothers on anti-seizure medication, according to the same source.
Increase in Seizure Activity
Seizure activity may increase in pregnancy. According to eMedTV, around 25 to 40 percent of women have an increase in seizure activity during pregnancy. Changes in the way the body processes medications due to hormone levels and metabolic changes during pregnancy can cause seizure activity to increase or, in some cases, to decrease, the Mayo Clinic reports.
Pregnancy Complications
Women with epilepsy may develop severe nausea and vomiting, anemia or low red blood cell count and increased vaginal bleeding during and after pregnancy, the Mayo Clinic reports. High blood pressure, placental abruption, a premature separation of the placenta from the uterine wall, premature delivery and low birth weight may also complicate pregnancy.
Pregnancy Loss
Pregnancy loss past 20 weeks of pregnancy increases in women with epilepsy to around 2 to 14 percent of epileptic women as compared to 2 to 7 percent of women without epilepsy, according to the Epilepsy Foundation.
Post-Delivery Complications
Infants whose mothers have a seizure disorder have a slightly higher risk of having seizure disorder themselves, according to the Epilepsy Foundation. Hemorrhagic disorder of the newborn may occur after birth because anti-seizure medications disrupt vitamin K transport across the placenta. Vitamin K helps synthesize clotting factors in the blood. Giving vitamin K orally in the last month of pregnancy helps prevent this complication, according to the Epilepsy Foundation.
