Introduction: Epilepsy is a chronic neurological disorder affecting approximately 0.3–0.8% of the obstetric population. Pregnant women with epilepsy are at increased risk of preterm labor, fetal growth restriction, and higher cesarean delivery rates. Physiological changes during pregnancy alter antiepileptic drug pharmacokinetics, potentially lowering the seizure threshold. This study aimed to evaluate the impact of antiepileptic drug use on perinatal and early neonatal outcomes in pregnant women with epilepsy. Methods: This retrospective observational study included 97 pregnant women with epilepsy who delivered at the Ankara Bilkent Perinatology Clinic between January 2021 and October 2023. Patients were categorized into three groups: no medication (n=17), monotherapy (n=73), and polytherapy (n=7). Demographic characteristics, 1- and 5-minute APGAR scores, umbilical cord blood gas parameters, early neonatal complications, and NICU admissions rates were analyzed. Results: Maternal age (p=0.021) and umbilical cord pH values (p=0.031) differed significantly between the groups. The polytherapy group demonstrated a higher median cord pH. No significant differences were observed in birth weight, gestational age, APGAR scores, or neonatal complications. The cesarean delivery rate was higher in the polytherapy group (p<0.001). Conclusion: The impact of antiepileptic drug use on perinatal and early neonatal outcomes appears limited in this study. Higher cord pH values and increased cesarean rates in the polytherapy group may reflect closer monitoring or preventive clinical decision making. Given the retrospective design of the study and the limited sample size, these findings should be interpreted with caution. Larger prospective studies are needed to clarify the relationship between antiepileptic therapy and pregnancy outcomes.
Bastemur et al. (2026) studied this question.