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20 - Risks of birth defects in children born to mothers with epilepsy

from Part V - Family planning, pregnancy, and parenting

Published online by Cambridge University Press:  02 November 2009

Aline T. Derdiarian
Affiliation:
California, USA
Yasser Y. El-Sayed
Affiliation:
Department of Gynecology and Obstetrics, Stanford University Medical Center, Standford Hospital, 300 Pasteur Drive, Stanford, CA 94305
Martha J. Morrell
Affiliation:
Columbia University, New York
Kerry L. Flynn
Affiliation:
Columbia-Presbyterian Cancer Center, New York
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Summary

Dr Aline Derdiarian is a practicing neurologist and epilepsy specialist. She lectures widely on this topic. She is currently in private practice in California. This chapter also includes further information on gynecological and obstetrical care of women with epilepsy. This information should provide a good basis for discussion between the woman with epilepsy, her neurologist and obstetrician/gynecologist.

MJM

Introduction

Every pregnant woman wants to be certain that her baby is born healthy. Although women with epilepsy have a somewhat higher risk of having a child with a birth defect than do women without epilepsy, many overestimate the risk, partly because of the many misconceptions about epilepsy and pregnancy, even today. With the help of her physician or nurse, each woman with epilepsy can make a realistic assessment about the risks of pregnancy given her particular situation. It is important to remember that, with good preconception and prenatal care, more than 90% of women with epilepsy will have a normal, healthy infant.

Causes and mechanisms of birth defects/adverse outcomes

Birth defects include major congenital malformations and minor anomalies. Major malformations are significant physical defects which may be life threatening and generally require surgical treatment. Four to eight percent of children born to mothers with epilepsy have a major malformation, as compared to 2–4% of children born to mothers without epilepsy. Minor abnormalities are defined as variations from normal appearance that have no effect on health or well-being.

Type
Chapter
Information
Women with Epilepsy
A Handbook of Health and Treatment Issues
, pp. 215 - 221
Publisher: Cambridge University Press
Print publication year: 2003

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References

Morrell MJ. Pregnancy and epilepsy. In The Epilepsies 2, ed. RJ Porter, D Chadwick. Butterworth-Heinemann, Boston, 1997, pp. 313–32
Morrell, MJ.Effects of epilepsy on women's reproductive health. Epilepsia 1998; 39(S8):S32–7Google Scholar
Quality Standards Subcommittee of the American Academy of Neurology. Practice Parameter: management issues for women with epilepsy (summary statement). Neurology 1998; 51:944–8
Seizure disorders in pregnancy. Am Coll Obstet Gynecol Phys Educ Bull 1996; 231:1–13
Yerby, MS, Leavitt, A, Erickson, DM. Antiepileptics and the development of congenital anomalies. Neurology 1992; 42(S5):132–40Google Scholar
Zahn, CA, Morrell, MJ, Collins, SD, Labiner, DM, Yerby, MS.Management issues for women with epilepsy: a review of the literature. American Academy of Neurology Practice Guidelines. Neurology 1998; 51:949–56Google Scholar

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