Posts Tagged Teratogenicity
Maternal use of antiepileptic agents during pregnancy and major congenital malformations in children
Bromley RL, Weston J, Marson AG.
JAMA 2017; 318:1700-1701.
Is maternal use of antiepileptic drugs during pregnancy associated with major congenital malformations in children?
Certain antiepileptic drugs were associated with increased rates of congenital malformations (eg, spina bifida, cardiac anomalies). Lamotrigine (2.31% in 4195 pregnancies) and levetiracetam (1.77% in 817 pregnancies) were associated with the lowest risk and valproate was associated with the highest risk (10.93% in 2565 pregnancies) compared with the offspring of women without epilepsy (2.51% in 2154 pregnancies).
Weston J, Bromley R, Jackson CF, et al. Monotherapy treatment of epilepsy in pregnancy: congenital malformation outcomes in the child. Cochrane Database Syst Rev 2016; 11:CD010224.
Both references are cited in the neurochecklist:
[Abstract] Antiepileptic drug treatment during pregnancy and delivery in women with epilepsy – A retrospective single center study
Pregnancies in women with epilepsy (WWE) increased significantly during our 11-year study period (41% increase).
Twelve different AEDs were prescribed to WWE during pregnancies in the 11-year period investigated (2005-2015) with Lamotrigine (36.1%), Carbamazepine (25.0%), and Valproic Acid (13.5%) most commonly used.
Valproic acid use was markedly reduced comparing the years 2005-2010 (18.4%) and 2011-2015 (9.4%), a reduction of 48%.
Unfortunately, a trend towards an increase in treating WWE with more than one AED was observed.