The majority of babies born to mothers with epilepsy are normal. Nevertheless, women with epilepsy, especially those receiving anti-epileptic drugs, have an increased risk of giving birth to a baby with major malformations , minor anomalies or dysmorphic features compared to women without epilepsy. It is possible that some of this risk is caused by a genetic predisposition for birth defects inherent in some families. Pre-natal screening can detect many major malformations and anomalies. Anticonvulsant treatment during pregnancy should be chosen so as to minimise the occurrence of convulsions.
Anticonvulsant therapy is associated with an increased risk of neural tube defects.
Periconceptual folic acid supplementation is therefore of particular importance for women with epilepsy. Before and during pregnancy, the aim should be the lowest dose of anticonvulsants that protects against seizures. Pre-pregnancy withdrawal of anticonvulsants could be considered for selected women and a change from poly to monotherapy could be considered for some others. Vitamin K . All women with epilepsy should be advised to take increase daily folic acid intake while attempting to conceive and for at least 12 weeks after conception.