Get Healthy!

• Posted September 17, 2025

Pregnant Women With Epilepsy Not Consulting With Neurologists, Missing Out On Important Care

Roughly half of pregnant women with epilepsy see a neurologist while they’re expecting, an oversight that could put both mom and baby at risk, researchers say.

About 45% of women with epilepsy didn’t see a neurologist at all in the year leading up to delivery, researchers reported this week at a meeting of the American Neurological Association in Baltimore.

That represents missed opportunities to prevent complications like seizures, birth defects and developmental delays, researchers said.

“While there is no specific recommendation that women see a neurologist before or during pregnancy, these experts play a key role in implementing risk-reduction strategies that improve outcomes for women and their babies,” lead researcher Dr. Chloe Hill, an assistant professor of neurology at the University of Michigan, said in a news release.

Certain anti-seizure medications like valproate, phenobarbital and topiramate have been linked to an increased risk of birth defects, previous studies have shown.

On the other hand, uncontrolled seizures are also dangerous, increasing the risk of pregnancy complications, preterm birth and miscarriage, researchers said.

Second-generation anti-seizure meds like levetiracetam, oxcarbazepine, gabapentin and zonisamide have not shown an increased risk for birth defects, according to a July article in the journal Neurology.

Neurologists can direct women with epilepsy to these safer options, and also make sure they’re taking folic acid supplements that decrease risk of spina bifida and other birth defects, researchers said.

For the new study, they analyzed data for nearly 2,400 women with epilepsy who delivered babies between 2016 and 2021. In the year prior to delivery, 55% consulted with a neurologist.

About 3 in 5 of the women (59%) were taking one anti-seizure medication; 17% were on two; and 5% were on three or more, results show. About 19% weren’t taking any anti-seizure drug.

Overall, 3 in 5 (62%) were taking an anti-seizure med that’s recommended for pregnancy, researchers found.

But nearly 1 in 7 (13%) were taking an anti-seizure drug that increases risk of birth defects, results showed.

Women who consulted with a neurologist were more likely to be on a safe anti-seizure medication – 74% versus 48% for those who didn’t see a neurologist.

They also were less likely to stop taking their anti-seizure med during pregnancy, 8% versus 33%.

“Pregnant women with epilepsy and their infants have a higher risk of poor outcomes compared to the general population,” Hill said. “Seeing a neurologist during pregnancy is one important means to promote clinical practice guideline-concordant care for pregnant women with epilepsy, which supports safer pregnancies and healthier outcomes for women with epilepsy and their babies.”

Findings presented at medical meetings should be considered preliminary until published in a peer-reviewed journal.

More information

The Epilepsy Foundation has more on anti-seizure medications during pregnancy.

SOURCE: American Neurological Association, news release, Sept. 15, 2025