Greater Coordination, Integration Necessary for Pregnant Women With Epilepsy

An integrated and coordinated approach consisting of proper guidance from certified providers is needed to improve the reproductive health of women with epilepsy, according to authors of a study published in Seizure: European Journal of Epilepsy.¹ Furthermore, with the help of pharmacists, prioritizing communication and antiseizure medication (ASM) management can also improve reproductive outcomes among this population.

“People living with epilepsy have a lot of concerns about their reproductive health, such as the safety of taking ASMs while breastfeeding or how the drugs interact with contraceptives, and those concerns are often not being addressed properly in clinical practice,” Laura Kirkpatrick, MD, assistant professor of pediatrics and neurology at the University of Pittsburgh’s School of Medicine, said in a news release.² “They are not getting up-to-date education on these issues.”

Despite this well-known gap in understanding of the epilepsy and pregnancy relationship, experts are aware of the potential risks epilepsy experiences can have for pregnant mothers and their expected children. According to authors of the current study, epilepsy during pregnancy can lead to increased risk of miscarriage, stillbirth, preterm birth, antepartum and post hemorrhage, hypertensive disorders, fetal growth restriction, congenital fetal abnormalities, infant death, and maternal death.¹

READ MORE: Maternal Mental Health, Education Are Key Predictors of Pediatric Nutrition

Previous Gaps in Understanding Epilepsy’s Impact on Pregnancy

The gaps in understanding epilepsy and pregnancy collectively were further revealed in a South African Family Practice study. Similar to the current study, these researchers explored the knowledge and understanding of women with epilepsy and how their condition impacted pregnancy. Unsurprisingly, they found significant potential for increased medical risks during childbearing years stemming from experiences of epilepsy.³

“Within expert reviews and guidelines on the management of epilepsy, there remains an absence of research on the perspectives of women with epilepsy themselves,” wrote authors of the study.¹ “The experiences of pregnant women with epilepsy are essential for informing the development of effective quality of care interventions to improve health outcomes.”

Amid these gaps in both care and understanding toward epilepsy’s relationship with pregnancy outcomes, researchers aimed to simply identify pregnancy and reproductive health experiences among women with epilepsy, adding more to the current literature on this unique but potentially detrimental link. To do this, they conducted a systematic review and thematic synthesis of literature from 2012 to 2024.

They assessed medical, social science, and psychology databases for all associations of pregnancy and epilepsy, exploring a slew of search terms related to either. The only studies they included in the analysis were empirical, peer-reviewed, and focused on experiences of epilepsy among each woman’s full pregnancy—from pre-pregnancy through to the postnatal period.¹

The final analysis consisted of 11 publications retrieved from 9 studies. Researchers assessed the literature and presented the 3 themes and various subthemes they uncovered throughout the 12-year time period.

Women With Epilepsy and Their Pregnancy Experiences

The 3 themes were simple and encapsulated women’s full pregnancy experience. They included prepregnancy, pregnancy, and postnatal experiences, concerns, and needs of women with epilepsy included in the study.

“Across the prepregnancy, pregnancy, and the postnatal period, women experience epilepsy-related concerns, anxieties, and stigma in a context of inadequate and/or conflicting health information,” they continued.¹

From their own needs and concerns to those of their children, pregnant women with epilepsy must take a particular approach toward care compared with other patients. According to the subthemes that real women with epilepsy reported in this study, they are significantly concerned about babies inheriting epilepsy, how ASMs impact children, how seizures impact pregnancy, and so much more.

Then, even after pregnancy, participants reported experiences and challenges in balancing a newborn’s health needs with those of their own, as well as a reduction in confidence in caring for a child while experiencing epilepsy.

Potential Roles for Neurologists, Pharmacists, and Other Providers

As researchers uncovered and noted, a huge gap in epilepsy-related care among expecting women exists. They suggested that greater attention is required for this unique population, despite just fewer than 0.8% of all births occurring among women with epilepsy. Ultimately, this population is significantly at risk, and providers like neurologists and pharmacists alike can contribute to filling in these persistent gaps in care.

“To address inertia in care improvements, a shift towards integrated, coordinated is needed. Implementing guidance for care pathways that involve either epilepsy specialist midwife or joint neurologist, and obstetrician clinics could improve coordination,” concluded the authors.¹ “Additionally, compassionate, honest communication should be prioritized to support shared pregnancy and ASM management decision-making with women.”

READ MORE: Women’s Health Resource Center

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REFERENCES

1. Annalise W, Anita H, Judith D, et al. Experiences of pregnancy and reproductive health for women living with epilepsy: a systematic review. Seizure. 2025;133:106-113. https://doi.org/10.1016/j.seizure.2025.10.011

2. Anaya FJ. Latest findings on epilepsy and pregnancy are not reaching clinical practice. University of Pittsburgh. January 10, 2025. Accessed December 15, 2025. https://www.health.pitt.edu/news/latest-research-findings-epilepsy-and-pregnancy-are-not-reaching-clinical-practice

3. Baloyi MG, Khalema R, Adam S. What do women with epilepsy know about pregnancy? S Afr Fam Pract. 2024 Aug 16;66(1):e1-e9. doi: 10.4102/safp.v66i1.5937.