Women with epilepsy also may have an increased risk for obstetric complications. Low infant birth weight, preterm delivery, stillbirths, labor induction, and operative delivery by cesarean section and forceps have all been observed with increased frequency among women with epilepsy. Overall, perinatal mortality is increased in pregnancies complicated by epilepsy. Another potential perinatal complication in neonates of women with epilepsy is the hemorrhagic disease of the neonate related to the use of enzyme-inducing AEDs by the mother. This differs from the classic hemorrhagic disease of the newborn, since its onset is earlier (< 24 hours), and it might be preventable by the use of vitamin K by the mother.34 More than 40 cases have been reported since 1958, but the true incidence of the problem has not been studied.35 Currently, the American Academy of Neurology recommends that pregnant women with epilepsy who are taking AEDs receive vitamin K (10 mg/day orally) from the 36th week of gestation until delivery29,30,36. This does not supplant the current recommendation from the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists that every neonate should receive 1 mg of vitamin K parenterally at birth.
Reviewed February 2004 by Cynthia Harden, MD, Weill Cornell Medical College.
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