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 one particular epilepsy drug that can cause birth defects. The guidelines are published in the April 27, 2009, print issue of Neurology, the medical journal of the American Academy of Neurology, and were presented at the Academy's Annual Meeting in Seattle held this April.
The guidelines recommend women with epilepsy avoid taking the drug valproate during pregnancy which has been linked to birth defects
The guidelines also suggest, 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.
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.
The guidelines also state that physicians of women with epilepsy should consider avoiding the epilepsy drugs phenytoin and phenobarbital in order to prevent the possibility of decreased thinking skills in children. In addition, the guidelines recommend women with epilepsy be warned that smoking may increase substantially the risk of premature contractions and premature labor and delivery during pregnancy.