Historically there seemed to have been no hope of having healthy, normal babies for women taking epilepsy medication, as these medications are believed to increase the risk of defects in babies. But newer generation epilepsy medication could finally solve this problem, according to a study published in the Journal of American Medical Association.
Hope for epileptic women wanting to have children
According to Dr Page Pennel of the Professional Advisory Board for the Epilepsy Foundation, the general message that doctors gave patients taking antiepileptic medication was that they cannot have children, “So it really was an unfortunate situation when young women or even teenagers were told that their whole life-course was determined by the fact that they need an epilepsy medication.” However, the research shows that newer epilepsy medication used in the first trimester has no such risks.
How did they conduct the study?
In the study, data of 837 795 infants from Denmark were used by gaining access to the Medical Birth Registry; data of prescriptions filled was drawn from the Registry of Medicinal Product Statistics.
Learning disabilities and epilepsy medication
Dr Pennel continues to say that they had some consistent findings that revealed that medications like Vaproic acid, for instance, holds a very high risk for children to develop learning disabilities and even autism spectrum disorder. However, they also found that other epilepsy medications can be quite safe without giving any indication of increased risk of children developing learning disabilities.
The study did not focus on other risks such as miscarriage or learning development problems, but rather focused on birth defects.
Gaps in the study
Dr Pennel is of meaning that the study’s major limitation is that the epilepsy medications are grouped into only two broad groups – older and newer medication. He says that within those categories some medications are safer than others. An example of that would be topiramate, which is a second-generation medication that was found to be safe by the study. However, the FDA issued a warning that “there is positive evidence of human foetal risk based on human data”.
Uses of epilepsy medication
It is important to note that epilepsy medication is not used for the sole purpose of treating epilepsy. It is commonly also prescribed for patients with bipolar mood disorder, patients suffering from chronic migraines, and so on. Second-generation epilepsy medications started to appear on shelves in pharmacies in the early 1990s.
Birth defects found in the babies of women taking epilepsy medication
Primary birth defects could include cleft palate, neural tube defects, skeletal abnormalities, and congenital heart and urinary tract defects. Taking certain epilepsy medication, like valproate (valproate sodium (Depacon), divalproex sodium (Depakote, Depakote ER) and valprioc acid (Depakene, Stavzor)) or taking a combination of epilepsy medications, can dramatically increase the risk of your baby having impaired cognitive function.
The Epilepsy Foundation found that the babies of women taking epilepsy medication have a 4% to 8% risk of being born with defects, whereas the risk of women not taking epilepsy medication is 2% to 3%. Combining different epilepsy medication holds the biggest risk for the baby.
What if pregnant women with epilepsy don’t take medication at all?
This is also not an option, as uncontrolled seizures can deprive the baby of oxygen and increase the risk of stillbirth or miscarriage.
So what options are left?
You have to work closely with an experienced doctor or specialist during your pregnancy. The healthcare provider could prescribe the safest possible dosage and type of medication. He/she will probably steer clear of valproate and will opt not to prescribe more than one medication, especially in the first trimester or even throughout the pregnancy.
It is important to remember that close monitoring of the medication’s levels in your blood is done, as during or just after delivery, the level of this medication could decrease, which will put you at higher risk of an episode.
Uncontrolled seizures pose a bigger risk to your baby than the epilepsy medication.