The U.S. Food and Drug Administration (FDA) lists oxcarbazepine in Pregnancy Category C. This indicates that caution is advised, but the benefits of the medication may outweigh the potential risks. There have been no well-controlled studies in women, but studies in animals have shown some harm to the fetus.

In general, the risk of defects is higher for women who take more than one AED and for women with a family history of birth defects.

Women who are capable of becoming pregnant should take at least 400 mcg (0.4 mg) of folic acid (folate) daily to help prevent a type of birth defect called a neural tube defect. (The best-known of these is spina bifida, in which the spinal cord is not completely enclosed.) Women at high risk, such as those with a history of this kind of defect in a previous pregnancy, should take 4000 mcg (4 mg) daily, beginning before they become pregnant.

About 20% to 35% of women have seizures more often during pregnancy because of changes in hormones or changes in how their seizure medicine is handled by the body. The doctor may recommend checking the level of medication in the blood regularly during pregnancy so that the dosage can be adjusted as needed.

No studies have been performed to demonstrate the effect of specific seizure medicines during labor and delivery. Possible causes of seizures include:

• failure or inability to take medication
• sleep deprivation
• hyperventilation
• stress
• pain

Some oxcarbazepine is passed through breast milk. If you want to breastfeed your baby, check with your doctor about what seizure medicine would be best for you.

Reviewed by Steven C. Schachter, MD
Submitted: 01/03/08