Epilepsy and pregnancy: What we need to know

From pre-conception to postpartum, here’s all that you need to know about epilepsy’s effect on pregnancy.

Epilepsy is a chronic brain disorder that can lead to brief episodes of involuntary movement triggered by abnormal electrical activity in the brain. For women with epilepsy, pregnancy can be a challenging phase. In an interview with HT Lifestyle, Dr Atul Prasad, vice chairman and HOD - neurology, BLK MAX Super Speciality Hospital said, “Women with epilepsy can have healthy pregnancies, but they face increased risks, including seizure exacerbation, medication teratogenicity, and complications such as preeclampsia or fetal growth restriction.”

The doctor further explained how epilepsy can complicate pregnancies, and what mothers need to know.

Pre-conception planning:

“Ideally, women with epilepsy should consult their healthcare team—neurologists and obstetricians—before conception. This allows for a review of seizure control and antiseizure drugs. Consider switching to lower-risk anti-seizure medications (ASMs) and aim for monotherapy at the lowest effective dose,” added the neurologist.

Seizure management during pregnancy:

"Seizure frequency remains unchanged in approximately 50% of women but may worsen in 30%. Generalized tonic-clonic seizures (GTCS) are particularly dangerous due to the risk of hypoxia, trauma, miscarriage, and sudden unexpected death in epilepsy,” the doctor added. Also read | Epilepsy: Causes, risks and tips to live seizure-free

Pregnancy complications:

Epilepsy can lead to higher risk of miscarriage, preterm birth, fetal growth restriction, preeclampsia. The doctor added that epilepsy does not increase the risk of C-section, but uncontrolled seizures may necessitate surgical delivery.

Can epilepsy affect pregnancy? (Shutterstock)

Prenatal monitoring:

“Enhanced prenatal screenings, including detailed ultrasounds (18–22 weeks) and fetal echocardiography, help detect structural abnormalities. Women on ASDs, particularly older agents like phenobarbital, may have higher risks of preterm birth or low birth weight. Monitoring for obstetric complications, such as preeclampsia, is also essential,” said Dr Atul Prasad.

Labor, delivery, and postpartum:

“Most women with epilepsy deliver vaginally, but stress and sleep deprivation during labour may trigger seizures. Postpartum, ASD doses may need readjustment as pregnancy-induced metabolic changes reverse. New mothers should prioritise sleep and seek help to mitigate seizure risks,” highlighted the neurologist.

Emotional and psychological support

Pregnancy with epilepsy can heighten anxiety. Access to counselling, support groups, and education empowers women to navigate challenges confidently, emphasised Dr Atul Prasad.

Disclaimer: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.