Taking Certain Epilepsy Drugs During Pregnancy Linked to Higher Risk of Birth Defect

A new study from the University of Liverpool and University of Manchester revealed that pregnant women taking certain epilepsy medication have increased risk of giving birth to babies with defect or malformation.

The study, published in the journal Cochrane Database of Systematic Reviews, showed that children exposed to certain types antiepileptic drugs (AED) in the womb are at a higher risk of being born with birth defects.

"This is a really important review that informs complex discussions during consultations about epilepsy treatment choices for women of childbearing potential, who represent around a third of people with epilepsy worldwide," said Tony Marson, a Professor of Neurology at University of Liverpool's Institute of Translational Medicine, in a press release.

For the study, the researchers conducted a systematic review of 50 published studies. By analyzing these studies, the researchers were able to understand whether pregnant women exposed to AED during their pregnancy were at higher risk of having a child with malformation.

The researchers found that infants exposed to the AED sodium valproate were 10 percent more likely to develop significant birth defect, with the risk rising as the drug dose increases. The types of birth defects that were linked to AED include skeletal and limb defects, cardiac defects, craniofacial defects and neural tube defects.

Exposure to AED carbamazepine, topiramate or phenytoin was linked to increased risk of birth defects. However, the researchers were not certain what kind of birth defect. Children exposed to Phenobarbital were more likely to develop cardiac defects.

On the other hand, the researchers were not able to find increased risk of birth defects in children exposed to lamotrigine or levetiracetam, compared to control children. Lamotrigine or levetiracetam had also lower risk of birth defects when directly compared to carbamazepine, topiramate or phenytoin.

These findings suggest that lamotrigine or levetiracetam holds the lower risk of AED-associated birth defects. Pregnant women with epilepsy are advised to continue taking their AED. Due to this, the researchers urged healthcare providers to carefully and collaboratively aim to balance the mental health and fetal risk when devising treatment methods.