Obstetric and Neonatal Outcomes in Epilepsy-Complicated Pregnancies: The Impact of Levetiracetam Monotherapy

INTRODUCTION: To evaluate the impact of levetiracetam monotherapy on obstetric and neonatal outcomes in pregnant women with epilepsy.
METHODS: The present retrospective cohort study included pregnant women with epilepsy followed at our center from the first trimester onward. Patients with seizures during pregnancy, polytherapy use, and multiple gestations were excluded. Patients were divided into a non-medicated group and a levetiracetam monotherapy group. Demographic, obstetric, delivery, and neonatal outcomes were compared.
RESULTS: A total of 74 patients were included in the study; 22 (29.7%) were assigned to the non-medicated group, and 52 (70.3%) were included in the levetiracetam group. No statistically significant differences were observed between the groups in maternal age, obstetric history, duration of epilepsy, gestational age at delivery, and APGAR scores. Neonatal birth weight was significantly lower (p = 0.042) and neonatal intensive care unit admission rates were significantly higher in the levetiracetam group (p = 0.047).
DISCUSSION AND CONCLUSION: Levetiracetam monotherapy was associated with lower neonatal birth weight and higher NICU admission rates, without significant differences in other major perinatal outcomes. These findings suggest that levetiracetam may represent a relatively safe treatment option during pregnancy with appropriate patient selection and close monitoring; however, larger prospective studies are needed.

Keywords: Epilepsy, Pregnancy, Perinatal outcomes, Neonatal intensive care unit