The use of antiepileptic drugs and their effects in pregnancy.

Background/aim: Epilepsy is one of the most common chronic neurological diseases. It can affect patients throughout their entire lives, including the reproductive years. It is estimated that epileptic women account for three to five births per 1000 births. Although the use of antiepileptic drugs (AEDs) during pregnancy has been associated with major congenital malformations in the fetus, many patients cannot discontinue the drugs before pregnancy due to the risk of seizures that may harm the mother as well as the child. In this study, our aim was to examine the follow-up findings of pregnant women who were epileptic and using AEDs during pregnancy and delivery, and to contribute to the literature on this subject, for which studies are still ongoing.

Materials and methods: Sixty epileptic pregnant women and 60 healthy pregnant women were included in the study. These women gave birth at the University of Health Sciences Zekai Tahir Burak Women's Health Application and Research Center. The women in the case group had applied to the neurology outpatient clinic between April 1, 2018, and April 1, 2019; were previously diagnosed with epilepsy by a neurologist; had started using AEDs before pregnancy; and had used AEDs in the first trimester.

Results: While the number of pregnancies per woman in the case group (1.75 ± 0.77) was significantly lower than that in the control group (2.25 ± 1.17), the rate of cesarean section deliveries and neonatal intensive care needs were found to be statistically significantly higher in the case group (68.3% and 20.0%, respectively) than in the control group (43.3% and 5.0%, respectively) (p < 0.05). There was no statistically significant difference between the groups in terms of birth week or birth weight.

Conclusion: Epileptic pregnancies have unique risks, differing from normal pregnancies. It is important that pregnant women with epilepsy be followed closely from the pregnancy planning period to delivery in cooperation with the physician.