What are the possible fetal risks of antiepileptic drugs during pregnancy?

Updated: Nov 08, 2018
  • Author: Carmel Armon, MD, MSc, MHS; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Answer

Answer

The AAN/AES guidelines state that the neonates of women with epilepsy who are taking AEDs probably have an increased risk of being small for gestational age (SGA) and possibly have an increased risk of a 1-minute Apgar score lower than 7.

Risks of antiepileptic drug polytherapy for fetus

In general, monotherapy is preferable to polytherapy when AEDs are used, and this is particularly true during pregnancy. The risk of major malformations is as high as 25% in infants of women who are taking 4 or more AEDs. [19] The AAN/AES guidelines state that AED polytherapy, as compared with monotherapy regimens, probably contributes to the development of major congenital malformations and to reduced cognitive outcomes in the fetus, and they recommend avoidance of polytherapy if possible.


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