Published Paper Details:

The use of antiepileptic drugs (AEDs) during pregnancy presents a significant clinical challenge, balancing maternal seizure control against potential teratogenic risks to the developing fetus. This review synthesizes current evidence on the teratogenicity of AEDs, focusing on mechanisms of action, drug-specific risks, and clinical management strategies. Valproic acid demonstrates the highest teratogenic potential, associated with neural tube defects (1-2%), cognitive impairment, and autism spectrum disorders. Phenytoin and carbamazepine carry moderate risks, including craniofacial abnormalities and fetal hydantoin syndrome. Newer AEDs such as lamotrigine and levetiracetam show safer profiles, with malformation rates of 2-3%. Key risk factors include polytherapy, high drug doses, and genetic susceptibility. Mitigation strategies emphasize preconception planning, including switching to safer AEDs, high-dose folic acid supplementation (4-5 mg/day), and close fetal monitoring. Multidisciplinary care involving neurologists, obstetricians, and genetic counselors is critical to optimize outcomes. Emerging research highlights the need for long-term neurodevelopmental studies of newer AEDs and personalized risk assessment tools. These findings underscore the importance of evidence-based, individualized treatment approaches for women with epilepsy of childbearing potential.