Can you have a safe pregnancy if you have a neurologic disease? Being pregnant or planning a pregnancy should be a celebrated time for you and your partner. Fortunately, you can have a successful, healthy pregnancy even if you have an existing neurological condition. Learn what you need to do before, during, and after your pregnancy.
The best preparation is consulting your obstetrician and neurologist before getting pregnant or as soon as you know you are pregnant. Your doctors will review your current medications and discuss the risks and benefits of continuing your medications. Certain medications must be continued during your pregnancy while some medications can be stopped. Do not suddenly stop your medicine without discussing with your doctors as this can pose harm to you.
The US Food and Drug Administration (FDA) categories for the teratogenicity or risk of birth defects from medications:
- Category A – Controlled human studies show no risks. (low risk)
- Category B – There is no evidence of risk in humans, but no controlled human studies are documented.
- Category C – Risk to humans has not been excluded.
- Category D – There is positive evidence of risk to humans from human or animal studies.
- Category X – Contraindicated in pregnancy. (high risk)
New neurologic diseases can develop during pregnancy while existing neurological conditions can fluctuate in severity.
- New-onset neurologic diseases – Seizures can develop from preeclampsia/eclampsia or posterior reversible leukoencephalopathy. Cerebral venous thrombosis is caused by blood clots in your brain leading to strokes. Back pain can develop or worsen during pregnancy. Carpal tunnel syndrome and sciatica can also be very common during pregnancy.
- Migraines are common in women of childbearing age. Most migraine medications are contraindicated during pregnancy due to the risk to the fetus. However, about 60-70% of migraines improve during pregnancy during the 3rd-4th months. Safer medications you can take for migraines during pregnancy include acetaminophen, caffeine, and anti-nausea medications.
- Seizures and epilepsy – Women with seizures can have a safe pregnancy with the right preparation. You and your doctor will optimize your seizure control with the fewest, safest medications before your pregnancy. Your medication dose will need to be adjusted during and after your pregnancy due to fluctuating levels from pregnancy.
- Multiple sclerosis – Relapses tend to be milder and less frequent during pregnancy. The risk of relapse increases in the first 3 months after delivery. You and your doctor will discuss the ongoing need for treatment during pregnancy given the risk of birth defects.
What you can do to increase your chances of a safe, healthy pregnancy.
- Take daily folic acid supplementation (0.4 mg/day). You need a higher dose (4 mg/day) if you had a pregnancy complicated by neural tube defects.
- Vegetarians should take vitamin B12 supplementation.
- Avoid drinking alcohol, smoking, or illicit drugs.
- Consult with your obstetrician and neurologist to review your medications.
Pregnancy is a time for celebratory time and should not be stressful. Taking the right preparation and consulting with your doctor can ensure a safe pregnancy. Just because you have a neurologic disease does not mean you cannot have a healthy pregnancy.
Make an appointment with our expert neurologists to discuss your options!