Epilepsy Is Not Likely to Be Teratogenic

May 09, 2002

NEW YORK (MedscapeWire) May 10 — Flying in the face of conventional wisdom, results from a meta-analysis presented at the Pediatric Academic Societies Annual Meeting suggest that women with epilepsy are no more likely than anyone else to have babies with birth defects, if they are not taking antieplieptic drugs (AEDs).

"Association of fetal malformations with untreated maternal epilepsy is controversial," write Irena Nulman and colleagues from the University of Toronto in Ontario, Canada.

The authors extracted data from published studies reporting pregnancy outcomes among women of untreated epilepsy compared with healthy controls. Of 74 articles, 5 retrospective and 5 prospective studies met the inclusion criteria and were included in the meta-analysis.

The risk for congenital malformations in offspring of women with untreated epilepsy (13 of 400 patients) was higher than in healthy controls (35 of 2492 patients), but this difference was not statistically significant (odds ratio, 1.92; 95% confidence interval [CI], 0.92-4.00). Compared with healthy controls, offspring of women treated with AEDs had a 3-fold increased risk of major malformations (odds ratio, 3.26; 95% CI, 2.15-4.93).

"We found no evidence of increased risk for major malformations in offspring of women who did not take antiepileptic medications during gestation," the authors write.

"This information is reassuring for women with epilepsy who do not need to take anti-epilepsy drugs," says study leader Gideon Koren, MD, professor of pediatrics, pharmacology, and medicine at University of Toronto, in the news release. "It is also important for...their physicians, who may choose to discontinue anti-epilepsy drugs during the first trimester in order to reduce risks of major malformations."

Pediatric Academic Societies Annual Meeting. 2002.

Reviewed by Gary D. Vogin, MD

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