Epilepsy in Pregnancy: Maternal and Fetal Outcomes of Antiepileptic Treatments

Abstract

Objective: To investigate the effects of various AEDs on maternal and fetal outcomes during pregnancy in a cohort of 135 women with epilepsy.

Study Design: A retrospective cohort study

Place and Duration of Study: This study was conducted at the K-health care hospital, Karachi during March 2023 to March 2024.

Methods: The cohort included 135 pregnant women diagnosed with epilepsy. Maternal seizure control, drug adherence, and fetal outcomes (e.g., congenital anomalies, birth weight) were analyzed.

Results: Maternal seizure control was achieved in 68% of patients, with a higher seizure-free rate in those on monotherapy compared to polytherapy. Fetal outcomes varied with the type of AED, with higher rates of congenital anomalies observed in polytherapy groups. Low birth weight was more common in pregnancies exposed to sodium valproate.

Conclusion: The choice of AEDs significantly impacts maternal seizure control and fetal outcomes. Monotherapy regimens, particularly lamotrigine and levetiracetam, were associated with better maternal seizure control and fewer adverse fetal outcomes compared to polytherapy regimens.