Pregnancy challenges for women with epilepsy include medication risks like valproate's link to autism and lower IQ, and the need for dose adjustments due to faster metabolism. A study followed 298 children of women with epilepsy to age 6, finding no difference in verbal abilities compared to healthy women's children, though medication levels in the third trimester had nuanced effects. Folate supplementation was beneficial, while acetaminophen showed risks. Further research is needed to understand the long-term effects of various epilepsy drugs and genetic factors influencing outcomes.