New Advice Given For Pregnant Women With Epilepsy

New guidelines were published today that show pregnancy for women with epilepsy is safe if they take the precautions given.

• Avoid using valproate/ valproic acid. The drug has been linked with birth defects and lower IQ when compared with other drugs sufferers can use.
• Avoid mixing anti-epileptic drugs.
• Avoid using phenytoin or phenobarbital as linked with lower IQ levels in children.
• Quit smoking. It has been found that epileptic women who smoke while pregnant increase their chances of giving birth prematurely.

Epileptic Mary Katherine Albritton, 29, has had two children with no complications: “It really breaks my heart to hear that women who are epileptic shy away from having children. It can be done.” she said.

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Valproate epilepsy drug could lower babies IQ

Mothers with epilepsy are able to have perfectly healthy children, ongoing research suggests however that sodium valproate, or just, “Valproate” taken by the epileptic mother, may lower a babies IQ.

Women with epilepsy usually need to keep taking their epilepsy drugs while pregnant, research suggests that some drugs could have harmful effects on the baby. The drugs are already known to transfer into the babies bloodstream, and there seems to be a higher risk of birth defects for babies if their mother has epilepsy. An ongoing study has suggested that birth defects are more common with sodium valproate (sometimes just called Valproate) which has been used for many years to prevent seizures.

The study measured the intelligence quotients (IQs) of 309 3-year-old children whose mothers had taken anti-seizure drugs for epilepsy while they were pregnant. It found that children whose mothers had taken lamotrigine, phenytoin, and carbamazepine had higher IQ scores than children whose mothers had taken valproate. Scores for children whose mothers had taken valproate were on average 6 to 9 points lower. The average person has an IQ of 100, with about half the population scoring between 90 and 110.

Usually, the main factor that predicts a child’s IQ is the IQ score of his or her mother. This was true of the children taking other anti-epilepsy drugs, but not for children taking valproate. This suggests that valproate made a real difference to what happened to the children. The effects on IQ were more noticeable when women were taking higher doses of valproate.

This study is part of a longer-term study. The researchers will complete their work when the children are aged 6.

Talk to your doctor about how your epilepsy should be treated while you’re pregnant, or trying to get pregnant. Your doctor can help you make sure you’re on the type of medicine that best controls your seizures, at the lowest dose. Your doctor might suggest you change to a different type of medicine, or to a lower dose, before you get pregnant.

He or she can also advise you about the dose of folic acid you need to take. Folic acid helps protect the growing baby against birth defects. If at all possible, speak to your doctor six months before you plan to start trying for a baby. That means you’ll have time to sort out any problems with changes to your medicine.

If you’d like to help doctors find out more about the effects of epilepsy drugs in pregnancy, you can register your pregnancy with the UK Epilepsy and Pregnancy Register (http://www.epilepsyandpregnancy.co.uk).

From:

Kimford J. Meador MD, Baker GA, et al. Cognitive function at 3 years of age after fetal exposure to antiepileptic drugs. New England Journal of Medicine. 2009;360:1597-1605.