Taking Anti-seizure Drugs When Pregnant: Is Your Baby at Risk?

Women with epilepsy may need to take anti-seizure or antiepileptic drugs (AEDs) while they are pregnant. These medicines help stop uncontrolled seizures caused by epilepsy. However, a 2022 research study showed that some AEDs may affect the unborn baby's health.¹

In the study, some AEDs were linked to an increased risk of babies having a condition that affects their brain and development. These conditions are called neurodevelopmental disorders.¹

What are neurodevelopmental disorders?

Neurodevelopmental disorders affect a person's development and the function of their brain. Examples of neurodevelopmental disorders include:²

1. Autism spectrum disorders (ASDs)
2. Attention deficit / hyperactivity disorder (ADHD)
3. Intellectual disorder (ID)
4. Learning difficulties
5. Cerebral palsy

Children with neurodevelopmental disorders can have issues seeing, hearing, or talking. They also may have problems with memory, learning, and behavior. This can change as they get older and may improve. However, some conditions listed above are permanent.²

What did the study look at?

The 2022 research study looked at children whose mothers had taken AEDs while they were pregnant. The researchers used data from health registers in Denmark, Finland, Iceland, Norway, and Sweden. They analyzed the health records from between 1996 and 2017 of about 4.5 million children.¹

The researchers were interested in the prescriptions for AEDs given to the children's mothers during pregnancy. They focused on the 10 most common AEDs used alone and the 5 most common AEDs used in combination. They then noted how many of the children had ASD, ID, or other neurodevelopmental disorders at 8 years old.¹

What were the results?

The study showed that some AEDs can affect a baby's health if the mother takes them during pregnancy. When mothers took one or more of these medicines, their child was at increased risk of having ASD or ID.¹

Autism spectrum disorders (ASD)

ASD is a neurodevelopmental disorder that affects how a person interacts with other people and the world around them. This includes how they behave and communicate. ASD symptoms typically appear by a child’s second birthday, but the condition can affect people at any age.³

Intellectual disorder (ID)

ID is a neurodevelopmental disorder that affects mental ability. It can impact the way a person learns and interacts with information. It also can affect their ability to do daily activities. For people with an ID, it can be difficult to live alone.⁴

Which anti-seizure meds are linked to neurodevelopmental disorders?

The researchers looked at pregnant women taking the following AEDs:¹

• Topiramate
• Valproate
• Common AEDs taken together (combination treatment)

They found that taking topiramate or valproate during pregnancy increased the risk of ASD and ID in children by 2 to 4 times.¹

Some combination treatments also seemed to increase the risk of neurodevelopmental disorders in children:¹

• Taking levetiracetam and carbamazepine together did increase risk.
• Taking lamotrigine and topiramate together did increase risk.
• Taking levetiracetam with lamotrigine did not increase risk.

The risk of neurodevelopmental disorders in children whose mothers take other AEDs is not yet known.^1,5

Should I stop taking AEDs if I am pregnant?

You may have concerns about the risks of taking AEDs when pregnant. These risks must be weighed against your risk of having an uncontrolled seizure.⁵

If you have epilepsy, you may need to take AEDs during your pregnancy. They are important to preventing uncontrolled seizures, and stopping an AED can lead to seizures or other problems. Always discuss your concerns with your doctor before stopping any medication.⁵