Epilepsy poses unique challenges to women during pregnancy. Pregnancy, hormonal changes and stress are some of the factors that can contribute to seizure events. An article published in the journal “Neurology” in 2000 by researcher M. Yerby revealed that more than 1 million women of child-bearing age live with epilepsy. Health care providers must monitor women with a history of epilepsy closely during pregnancy, as risk factors for mother and child are increased.
Epilepsy refers to a condition in the brain in which disrupted or abnormal signals between neurons lead to seizure activity. Someone is typically diagnosed with the condition after suffering multiple seizures. Epilepsy and seizures vary in type and severity. A seizure may last from a few seconds to multiple minutes.
Seizures present differently in different people. Some people having a seizure might simply appear to be staring off into space. On the other end of the spectrum, grand mal seizures can cause spastic muscle movements and loss of consciousness. Grand mal seizures are commonly followed by extreme fatigue and a need for sleep and may result in injury if the person falls during the seizure.
Generalized seizures, which women suffer from more often than men, affect both sides of the brain. Focal seizures, which are more prominent in men, affect only one side of the brain.
Many factors have the potential to cause epilepsy, including:
However, in 66 percent of patients with epilepsy, the cause is unknown or idiopathic.
Factors that may trigger seizure activity include:
Any woman with epilepsy who plans to become pregnant is advised to consult with her health care provider. A pregnant woman with epilepsy should receive careful monitoring throughout her pregnancy to protect the health of her and her baby. Experiencing seizures during pregnancy increases the risk of injury to the mother and her unborn baby because of the potential for falling. Women with seizures are also at a greater risk of having premature labor or miscarriages.
Studies indicate that one-third of pregnant women with epilepsy experience more seizures during pregnancy, one-third experience no changes in their pre-pregnancy seizure patterns and one-third have seizure-free pregnancies.
More than 90 percent of infants born to mothers with epilepsy are healthy. The likelihood of having a healthy infant increases when women talk with their doctors before becoming pregnant. Women are often advised to begin taking folic acid prior to conception, as many anti-seizure medications deplete stores of this vital nutrient.
Medication dosages may also need to be adjusted depending on a woman's pattern of seizure activity during pregnancy. Older forms of certain anti-seizure medications are known to pose a risk to the fetus. As such, your doctor may change some of your prescriptions.
Expectant mothers can further decrease their risk of seizures by:
Recent research reveals that unless a woman with epilepsy has a previous history of infertility issues, her chances of becoming pregnant are the same as those without epilepsy.
Studies suggest that approximately 1 percent of infants born to mothers with epilepsy develop the condition at some point during their lives. The risk increases if the mother's epilepsy was inherited.
While it’s by no means guaranteed that your baby will have a health condition if you have epilepsy, there are some medical statistics to explain where this myth comes from. According to the Epilepsy Foundation, babies born to mothers with epilepsy have a 4-6 percent chance of having a congenital disability, which is twice as high as babies born to mothers without epilepsy. In addition, developmental delays are seen in approximately 2-6 percent of babies born to mothers with epilepsy.
The majority of women with epilepsy don’t have seizures during labor and will not experience any complications. In the event that a seizure does occur, physicians should be prepared to administer the necessary medications to prevent harm to the mother and infant.
In the majority of instances, there is no reason why a mother can’t nurse her infant. Laboratory evaluations reveal that infants typically consume negligible amounts of anti-seizure medications through breast milk. However, ethosuximide, lorazepam, phenobarbital and primidone prescriptions may pose a risk. Thus, mothers planning on breastfeeding should work closely with their doctor so medications and dosages can be adjusted as necessary. Otherwise, infants may exhibit unusual sleepiness, appear less alert, fail to gain weight or have developmental delays.