Pregnancy and Epilepsy: Clinical Data and Adverse Outcomes of Pregnant Women with Epilepsy

Objectives: Pregnancy in women with epilepsy carries a higher risk for fetal development complications, including congenital malformations. In this study, data obtained from pregnant epilepsy patients in a tertiary epilepsy center were presented. Methods: In this study, 128 pregnancies of 110 pregnant women followed up in the epilepsy outpatient clinic between April 2011 and April 2021 were examined. Demographic data of the patients, antiepileptic drugs AEDs used, and pregnancy outcomes were reviewed retrospectively. Results: During pregnancy, 101 patients (78.9%) received monotherapy, and lamotrigine was the most commonly used drug in monotherapy. A two-drug combination was used in 18 patients (14.1%), and a three-drug combination was used in 5 patients (3.9%). Although the frequency of seizures did not increase in most patients, the frequency of seizures increased in 18 patients (14.1%) and decreased in 5 patients (3.9%). In our study, the intrauterine fetal loss occurred in five patients, newborn infants with congenital malformations in three patients, and neonatal death during delivery in one patient. The number of AEDs used in multivariate logistic regression predicted adverse outcomes such as intrauterine fetal loss, neonatal death, and newborns with congenital malformations. Conclusion: Management of pregnant patients with epilepsy is difficult for both mother and fetus. In our study, combination therapy was more associated with adverse outcomes for the fetus and newborn. Pregnancy should be planned, and seizure-free pregnancy should be targeted with low-dose monotherapy.