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Caring for pregnant women with long-term conditions: maternal and neonatal effects of epilepsy

02 May 2017
Volume 25 · Issue 5


Epilepsy affects around 1 in 100 people and every year around 2500 women with epilepsy become pregnant. Although most will have an uneventful pregnancy, pregnancy for women with epilepsy carries additional risks to their wellbeing and that of their developing fetus and their infant. For some women, these risks include worsening symptoms of epilepsy, increased mortality risks and less effective treatment of other conditions and comorbidities like depression. For the developing fetus and infant, exposure to antiepileptic drugs can affect organogenesis and later development. This article highlights essential knowledge about this condition in pregnancy and considers how midwives can contribute to working collaboratively in ways that optimise pregnancy outcomes for these women.

Worldwide, epilepsy is thought to affect approximately 1% of people (Grant, 2016). Though subject to various methodological (definitions of disease) and clinical issues (diagnostic criteria) this statistic equates to around 600,000 people having the condition in the UK (Joint Epilepsy Council of the UK and Ireland (JEC), 2011). Current best estimates suggest that 23% (about 139,000) of people diagnosed with the condition and receiving anti-epileptic drugs (AEDs) are women of reproductive age (12–50 years old) (JEC, 2011). This statistic equates to around 2500 pregnancies per year across the UK for women with epilepsy (WWE) (JEC, 2011). Of particular concern for WWE and health professionals are the risks posed to infant health due to tonic-clonic epileptic seizures and the effects of AED regimes (Veiby et al, 2013; Bromley et al, 2014). This article explores maternal and neonatal effects of epilepsy, its management and the use of AEDs for this condition and others for positive pregnancy outcomes. Having a greater understanding of this topic will help midwives appreciate the need for multi-professional and multi-agency working and why the provision of specialist advice and support is important.

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