TOPLINE:

Epileptic seizures during pregnancy were associated with increased risks for adverse maternal and foetal outcomes; risks for seizures during pregnancy were higher among women from low-income backgrounds and those with focal epilepsy.

METHODOLOGY:

• Researchers conducted a systematic review and meta-analysis to examine the effect of epileptic seizures during pregnancy on maternal and foetal outcomes.
• They identified 25 observational studies including 24,596 pregnancies through a systematic literature search across various databases.
• Maternal and foetal outcomes were compared between pregnant women with epilepsy who experienced seizures and those who did not experience seizures and those without epilepsy.

TAKEAWAY:

• Women with epileptic seizures during pregnancy had 62% higher odds of caesarean birth (odds ratio [OR], 1.62; P = .007), 2.2-fold higher odds of peripartum depression (OR, 2.20; P = .04), and 58% lower odds of miscarriage (OR, 0.42; P < .001) than those with epilepsy but no seizures during pregnancy.
• The risk for babies being born small for gestational age was 32% higher among women with epileptic seizures during pregnancy than among those with epilepsy but no seizures during pregnancy (OR, 1.32; P = .03).
• Pregnant women with epileptic seizures had 66% higher odds of preterm birth, 47% higher odds of having babies with low birth weight, and 44% higher odds of having babies who were small for gestational age than those without epilepsy (P < .05 for all).
• The odds of having a seizure during pregnancy were higher among women with focal vs generalised epilepsy and those from low-income vs high-income backgrounds (P < .001 for both).

IN PRACTICE:

"Women with focal seizures may require increased monitoring from preconception care through the postpartum period, and healthcare providers should be aware of the increased risk of seizures during pregnancy in these women," the authors wrote.

SOURCE:

This study was led by Oladipupo Olalere, Department of Metabolism and Systems Science, College of Medicine and Health, University of Birmingham, Birmingham, England. It was published online on October 31, 2025, in PLOS Medicine.

LIMITATIONS:

The studies differed in their definitions of epilepsy and seizures, which reduced the comparability across studies. Variable study quality and risk for bias weakened confidence in pooled estimates. Limited data were reported for many outcomes such as maternal mortality. 

DISCLOSURES:

This study was funded by the National Institute for Health and Care Research Programme Grants for Applied Research. The authors declared having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.