Levetiracetam Is Safe During Pregnancy

Pregnant women with epilepsy who control seizures with levetiracetam (Keppra, Keppra XR) can expect that it will not affect their child’s later development. Taken during pregnancy, the medication does not appear to be associated with developmental problems in preschool children, according to a recent study published in the journal Neurology.

The study is reassuring for pregnant women with epilepsy who must take levetiracetam. It involved 53 children exposed to the medication, 44 children whose mothers took valproate (another epilepsy medication) and 151 children whose mothers did not have epilepsy and did not take any drugs during pregnancy. The children were 3 to 4.5 years old. Tests evaluated their development in areas such as thinking, movement and language abilities.

Children exposed to levetiracetam did not differ from children who were not exposed to epilepsy drugs, the study found. However, children exposed to valproate scored an average of 16 points lower on movement tests, 10 points lower on expressive language tests and six points lower on language comprehension measures than those exposed to levetiracetam.

The risk of impaired intellectual outcomes in the children born to mothers taking levetiracetam during pregnancy appears the same as the general population. On the other hand, the valproate-exposed children had measurably lower intellectual tests scores, confirming what is known regarding valproate as having the most risk for pregnancy outcomes.

This carefully performed study affects the well-being of many women and children touched by epilepsy and helps physicians to appropriately counsel mothers with epilepsy.

Women with epilepsy who are trying to conceive must consult with a neurologist who specializes in epilepsy to determine if the seizures are under good control. Medications often play an integral role in controlling epileptic seizures. Most of them, except valproate, have a fairly low risk of causing birth defects. If a woman with epilepsy takes one of these medications, a neurologist will discuss the lowest effective dose to control seizures during pregnancy.

More than 90 percent of the babies born to women with epilepsy are normal and healthy.

This post was written by Cynthia Harden, MD, chief of epilepsy and electroencephalography for the North Shore-LIJ Health System.

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