May 17, 2011—The use of newer-generation antiepileptic drugs during the first trimester of pregnancy was not associated with an increased risk of major birth defects in the first year of life among infants in Denmark, according to a study in the May 18th issue of Journal of the American Medical Association (JAMA). The study also noted these same drugs are also prescribed for bipolar mood disorders and migraine headaches.
Among the live births included in the study (837,795), 19,960 were diagnosed with a major birth defect (2.4 percent) during the first year of life. Among 1,532 pregnancies exposed to lamotrigine, oxcarbazepine, topiramate, gabapentin or levetiracetam at any time during the first trimester, 49 infants were diagnosed with a major birth defect (3.2 percent) compared with 19,911 infants (2.4 percent) among 836,263 unexposed pregnancies. After adjusting for various factors, the authors found that exposure to lamotrigine, oxcarbazepine, topiramate, gabapentin or levetiracetam at any time during the first trimester was not associated with an increased risk of major birth defects.
Note: Topiramate, gabapentin and levetiracetam exposure during the first trimester was uncommon.
This study provides further support that with careful and informed medication selection, women with epilepsy and other neuropsychiatric disorders have the opportunity to have successful pregnancies with antiepileptic drugs that are safe for the developing baby.
“The progress in this area of research has been tremendous from just a few decades ago when women with these disorders were discouraged from having a family of their own,” said Dr. Page Pennell, chair of the Professional Advisory Board of the Epilepsy Foundation. “However,” Pennell added, “other studies provide even more detailed information about the best safety options among the drugs within this class of newer-generation antiepileptic drugs.”
Speaking with your health care provider that is aware of the latest findings on the risk profiles for each of the medications and taking supplemental folic acid beginning prior to conception can help assure a good pregnancy outcome and healthy newborn baby.
*Dr. Pennell was quoted in a CNN Health story on May 17, 2011, about this important topic.
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