Pregnancy complications in patients with epilepsy.

PURPOSE OF REVIEW: Epilepsy is a common neurological disorder affecting 0.4-0.8% of pregnant women. Preeclampsia, gestational hypertension, bleeding in pregnancy, induction of labour, caesarean delivery and major congenital malformations of the children occur more frequently in this group. The objective of this review is to evaluate the pregnancy and delivery complications including congenital abnormalities in women with epilepsy. This review comments on results of recently published studies including the Medical Birth Registry of Norway. A second aim of the review is to examine the effect of antiepileptic-drug treatment on pregnancy complications, and also their association with congenital abnormalities associated with these medications.

RECENT FINDINGS: Women with epilepsy have a higher risk of preeclampsia, gestational hypertension, bleeding in pregnancy and excessive bleeding postpartum. They also have higher incidence of congenital anomalies and delayed cognitive development in their children. It has been unclear whether the increased risk of complications is due to the epilepsy per se, the use of antiepileptic drugs, or the combination of both factors. Recent studies strongly indicate an association to the medications and the dose used in pregnancy.

SUMMARY: Several drugs commonly used in treatment of epilepsy are associated with increased pregnancy complications, as well as an increased risk of congenital abnormalities.