Women with epilepsy who had seizures in the year before pregnancy were more than three times as likely to have seizures during their next pregnancy, according to a 2026 Australian study of 1,345 pregnancies. Gram Research analysis found that a seizure-free year before pregnancy was linked to a lower risk.
Women with epilepsy who had seizures in the year before pregnancy were more than three times as likely to have seizures during their next pregnancy, according to a 2026 Australian study. Gram Research analysis of the findings also showed that about half of pregnancies in this group were affected by seizures, and that this rate stayed steady across several five-year periods starting in 1999. The study found that a seizure-free year before pregnancy was linked to lower risk. Women who did not take seizure medicines during pregnancy, who had not taken folate supplements beforehand, or who had focal epilepsy also faced higher risk. The researchers say these results highlight a group of women who need especially careful medical care during pregnancy. Anyone with epilepsy who is planning a pregnancy should talk with their neurologist and doctor.
Key Statistics
A 2026 Australian study of 1,345 pregnancies in women with epilepsy found that those who had seizures in the year before pregnancy were more than three times as likely to have seizures during their next pregnancy.
In the same study, between 48.2% and 53.9% of pregnancies were affected by seizures in each five-year period from 1999 onward, showing that the rate remained largely stable over time.
A 2026 Australian study found that women with epilepsy who did not take seizure medicines during pregnancy, or who did not use folate supplements before pregnancy, were more likely to have seizures while pregnant.
The Quick Take
- What they studied: The researchers wanted to know which factors, beyond recent seizures, make it more likely that a woman with epilepsy will have seizures during her pregnancy.
- Who participated: The study included 1,345 pregnancies in Australian women with epilepsy. All were first pregnancies. About 711 of these women had seizures in the year before becoming pregnant, and 634 had no seizures that year.
- Key finding: Women who had seizures in the year before pregnancy were more than three times as likely to have seizures during pregnancy. About half of all pregnancies in the study were affected by seizures, and this rate stayed stable over time.
- What it means for you: If you have epilepsy and are planning a pregnancy, a seizure-free year before conception may lower your risk. Keep taking your seizure medicine as prescribed unless your doctor advises a change, and talk with your care team about folate and a pregnancy plan.
The Research Details
The researchers compared two groups of women with epilepsy. One group had seizures in the year before becoming pregnant and was likely to keep having seizures during pregnancy. The other group had no seizures in the year before pregnancy. Together, the study looked at 1,345 pregnancies.
To find which factors mattered most, the team used a statistical method called multivariate logistic regression. This method checks many possible influences at the same time, such as type of epilepsy, medicine use, and folate intake, to see which ones are linked to seizures during pregnancy. It helps separate the effect of one factor from the others.
The researchers also tracked how often seizure-affected pregnancies occurred in five-year periods starting in 1999. This allowed them to see whether the rate had changed over time.
Comparing women with and without recent seizures lets researchers see how a seizure-free year is connected to pregnancy outcomes. Using a statistical method that accounts for several factors at once helps show which influences are most important, rather than looking at just one factor in isolation. Tracking results across many years also shows whether the problem is getting better or staying the same.
The study has a large sample of 1,345 pregnancies, which gives the results more statistical strength than a small study would. It was published in a peer-reviewed journal, meaning other experts reviewed it before publication. Because the study followed pregnancies across many years, the consistent rates over time add confidence. However, this type of study looks at associations and cannot prove that one factor directly causes seizures. It is best viewed as strong evidence that points to important risk factors.
What the Results Show
The main finding was clear: women who had seizures in the year before pregnancy had a much higher chance of seizures during their next pregnancy. The study found that this risk was more than threefold higher compared with women who had been seizure-free the year before. The researchers said that a seizure-free year being linked to lower risk was expected, but the size of the difference was not.
Across the study, roughly half of pregnancies were affected by seizures. The yearly rates across five-year periods were 50.5%, 53.9%, 50.3%, 52.8%, and 48.2%. These numbers stayed close to one another over more than two decades, which suggests that the problem has not become easier to manage over time.
The study also identified other factors linked to a higher chance of seizures in pregnancy. These included a shorter period of being seizure-free before pregnancy, focal epilepsy (seizures that start in one area of the brain), not taking seizure medicines during pregnancy, not using folate supplements before pregnancy, having epilepsy for a longer time, and having epilepsy start at a younger age.
Several factors appeared alongside the main result. Women who were not taking seizure medicines during pregnancy were more likely to have seizures, which suggests that medicine use matters but should always be decided with a doctor. Women who did not take folate before pregnancy also had higher seizure risk. Folate is a B vitamin that supports healthy early pregnancy development and is generally recommended for all women who may become pregnant. The study also showed that longer epilepsy and earlier onset were linked to more seizures during pregnancy, which can help doctors identify women who may need closer monitoring.
The researchers noted that they had reported earlier that seizures in the year before pregnancy were the main factor linked to seizures during pregnancy. This new analysis builds on that work by looking at additional risk factors. Reports from other studies on epilepsy and pregnancy have also found that women who have more recent seizures tend to face more seizures during pregnancy, which supports this pattern. The consistent link between recent seizures and pregnancy seizures fits with what clinicians already observe.
The study is observational, which means researchers observed what happened rather than assigning women to different treatments. This makes it impossible to say for certain that any single factor directly caused seizures. For example, women who skipped seizure medicine may have had more severe epilepsy to begin with.
The study included only first pregnancies, so the findings may not apply to women having second or later pregnancies. Seizure counts depend on what women and their doctors recorded, and some seizures may have been missed. The results come from Australian women, so they may differ in places with different healthcare systems or treatment practices. Finally, no statistical model can include every possible influence, so other unmeasured factors may also play a role.
The Bottom Line
Moderate to high confidence: Women with epilepsy who have had seizures in the year before pregnancy should expect a higher chance of seizures during pregnancy and should plan with their neurologist and obstetric team. Moderate confidence: A seizure-free year before pregnancy, and taking folate before conception, appear to be linked to lower risk. Women should not stop or change seizure medicines on their own. Decisions about medicine should be made with a doctor who can weigh seizure control against possible effects on the baby.
This research is most relevant to women with epilepsy who are planning a pregnancy or are already pregnant, along with their partners and care teams, including neurologists, primary care doctors, and obstetric providers. It is also useful for health professionals who counsel women with epilepsy. People who do not have epilepsy will find little direct application. Women who have had epilepsy for many years, who have focal seizures, or who have not been using folate may benefit most from early planning.
Planning ahead matters. Ideally, women with epilepsy would begin pregnancy planning with their doctors before trying to conceive, because a seizure-free period is best achieved before pregnancy begins. Folate supplementation is generally recommended before conception and during early pregnancy. Improvements in seizure control do not happen overnight, so it may take several months of careful management to reach a stable, seizure-free period. Women should discuss a realistic timeline with their doctors based on their individual situation.
Frequently Asked Questions
Does having seizures before pregnancy increase the chance of seizures during pregnancy?
Having seizures in the year before pregnancy was linked to a more than threefold higher chance of seizures during the next pregnancy, according to a 2026 Australian study of 1,345 pregnancies. A seizure-free year before pregnancy was associated with a lower risk.
Can taking folic acid before pregnancy lower seizure risk for women with epilepsy?
Women with epilepsy who did not take folate supplements before pregnancy were more likely to have seizures during pregnancy in a 2026 Australian study of 1,345 pregnancies. The study cannot prove folate directly prevents seizures, but it is generally recommended for women who may become pregnant.
Should I stop my seizure medicine when I get pregnant?
Women who did not take seizure medicines during pregnancy had higher seizure rates in this 2026 Australian study. Medicine changes should only be made with a neurologist or doctor, who can weigh seizure control against possible effects on the baby.
How often do women with epilepsy have seizures during pregnancy?
About half of pregnancies in women with epilepsy were affected by seizures in a 2026 Australian study of 1,345 pregnancies. Rates ranged from 48.2% to 53.9% across five-year periods starting in 1999, showing little change over time.
Want to Apply This Research?
- Log every seizure with date, time, type if known, and any known triggers such as missed medicine doses, poor sleep, or illness. Count the number of consecutive seizure-free days and review that count weekly. Also log daily folate intake and seizure medicine doses taken.
- Set daily reminders to take seizure medicine and folate at the same time each day. Use the app to flag any missed doses and send a prompt to contact your care team if a dose is skipped. Encourage regular sleep and stress management, since these are commonly reported seizure triggers.
- If you are planning a pregnancy, track seizure-free days and medicine adherence for at least 12 months before trying to conceive, and share the summary with your neurologist. During pregnancy, continue daily logging and bring the data to every prenatal and neurology appointment. Review trends monthly so that changes in seizure patterns can be addressed quickly.
This article summarizes a single observational study and is for general information only. It is not medical advice. Women with epilepsy who are planning a pregnancy or are already pregnant should speak with their neurologist and obstetric care team before making any changes to seizure medicines, folate, or other treatments. Never stop or change seizure medication without medical guidance, as sudden changes can increase seizure risk.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.