Does taking anti-epileptic drugs during pregnancy affect the fetus?

There is currently no drug in clinical medicine that can completely cure epilepsy, but it is possible to control the progression of the disease and reduce the number of epileptic seizures by taking anti-epileptic drugs. For pregnant women, if an epileptic seizure occurs during pregnancy, it will actually have a great impact on the healthy development of the baby, and may even cause hypoxia problems. So, will anti-epileptic drugs taken by pregnant women have any impact on the fetus?

In the normal population, the fetal malformation rate is 2%-3%. The malformation rate of offspring of epileptic women who take a single anti-epileptic drug increases by 2 to 3 times, and the malformation rate of offspring of epileptic women who take multiple anti-epileptic drugs is even higher. The effects of antiepileptic drugs on the intellectual development of offspring of women with epilepsy are still unclear. There is currently insufficient evidence to assess the teratogenicity of the newer antiepileptic drugs (gabapentin, levetiracetam, tiagabine, topiramate, and vigabatrin).

1. Before a woman with epilepsy plans to become pregnant, her treatment history should be reviewed and she should be informed of the effects of epileptic seizures and anti-epileptic drugs on pregnant women and fetuses.

2. If the patient's epilepsy seizures have been controlled before conception and the risk of recurrence is low, the patient may consider stopping medication before becoming pregnant, provided that the patient is informed of the impact of epilepsy recurrence on the pregnant woman and the fetus;

3. If the patient needs to use anti-epileptic drugs to control seizures during pregnancy, the risks of seizures and fetal malformations need to be fully communicated with the patient and family members;

4. If the patient needs to use anti-epileptic drugs to control seizures during pregnancy, a single drug with a low dose should be selected according to the type of seizure, and multi-drug combination therapy should be avoided as much as possible;

5. If the patient has given birth to a deformed child, she should consult an epilepsy specialist before getting pregnant again.

(III) Folic acid

Female epileptic patients taking anti-epileptic drugs have a significantly increased risk of neural tube defects and other malformations related to folate metabolism in their fetuses. All women with epilepsy should take 5 mg of folic acid daily during the first three months before pregnancy.

(IV) Vitamin K

1. Newborns born to epileptic women taking anti-epileptic drugs should be given an intramuscular injection of 1 mg of vitamin K after birth;

2. If the newborn born to an epileptic woman has other risk factors for hemorrhagic diseases (such as liver disease in the mother, expected premature birth, etc.), the pregnant woman should take 10 mg of vitamin K orally every day in the last month of pregnancy.