Major congenital malformations in children of women with epilepsy

Seizure : the Journal of the British Epilepsy Association
T TomsonD Battino

Abstract

It has been long known that the risk of major congenital malformations is increased among children of mothers with epilepsy. This is mainly due to the teratogenic effects of antiepileptic drugs although other factors, such as genetically determined individual susceptibility, are likely to contribute. Recent large scale prospective epilepsy and pregnancy registries have indicated that the rate of major congenital malformations may be at most two-fold higher than expected with exposure in utero to the presently most frequently used antiepileptic drugs such as carbamazepine or lamotrigine. Higher rates are consistently reported with exposure to valproate. The risk of teratogenic effects appears to be dose dependent and the lowest effective dose should thus be established before pregnancy regardless of which antiepileptic drug the woman is taking. Major changes such as switches between drugs should be avoided when pregnancy is established.

References

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Citations

Aug 13, 2015·The Journal of Infectious Diseases·Lynne M Mofenson
Mar 31, 2015·Seizure : the Journal of the British Epilepsy Association·D McCorry, R Bromley
Sep 16, 2016·Der Nervenarzt·B Müffelmann, C G Bien
Jun 29, 2017·International Journal of Psychiatry in Clinical Practice·Lingli KongChunxia Wang
May 3, 2018·Acta Obstetricia Et Gynecologica Scandinavica·Kim C DanielssonNils H Morken
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Dec 12, 2018·Expert Opinion on Pharmacotherapy·Anna Whelehan, Norman Delanty
Oct 30, 2019·Acta neurologica Belgica·Duygun Altıntaş Aykan, Yusuf Ergün
Jun 7, 2020·Drug and Therapeutics Bulletin·Anja Johansen-Bibby
Nov 12, 2020·Seminars in Neurology·Rebecca O'Dwyer
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Jun 27, 2021·Journal of the Neurological Sciences·Nathan A ShlobinJosemir W Sander

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