Pregnant Women With Anti-epilepsy

- Oct 26, 2019-

Professor Terence O'Brien, head of the Department of Medicine at the Royal Melbourne Hospital, believes that most people with epilepsy are able to have normal babies.


5,5-Dimethyloxazolidine-2,4-dione CAS 695-53-4 supplier told us that In pregnant women with epilepsy, the incidence of fetal abnormalities is 10%, which is 2 to 3 times that of the general population. Possible factors are antiepileptic drugs, occult disease in the mother, and seizures during pregnancy. It is worth noting that all anti-epileptic drugs have potential teratogenic effects.


The risk of seizure during pregnancy


5,5-Dimethyl-2,4-oxazolidinedione factory advised that seizures during pregnancy can cause damage to mothers and fetuses. Comprehensive tonic - clonic seizures may lead to fetal intracranial hemorrhage, miscarriage, stillbirth; comprehensive seizures and complex partial seizures may cause fetal heart rate to slow down; epileptic seizures are prone to sudden death, maternal mortality is 31%, fetal mortality is 48 %. Australia followed up the pregnancy process of 1826 patients with epilepsy. The results showed that normal birth without deformity accounted for 89%, birth malformation accounted for 5%, spontaneous abortion accounted for 3%, induced labor abnormality accounted for 1%, and stillbirth accounted for 1%, lost to follow-up 1% of the 140 patients who did not use antiepileptic drugs had birth defects, and 7.9% of the 1487 patients treated with antiepileptic drugs had birth defects.


Teratogenic effects of antiepileptic drugs


Dimethadione manufacturer told us that antiepileptic drugs can increase the risk of all types of birth defects, carbamazepine can cause neural tube defects and hypospadias; primidone can increase the risk of craniofacial deformity; phenytoin and phenobarbital can not only induce Craniofacial malformations may also lead to congenital heart disease and genitourinary infections; sodium valproate is the most toxic, not only has the teratogenic effects of the above drugs, but also induces skeletal deformities.


Sodium valproate teratogenic dose effect: Vajda et al investigated 210 patients with epilepsy and found that when the dose of sodium valproate was 11001 ~ 400mg / d, the cumulative risk increased.


Antiepileptic drugs affect neurocognitive function: Children with anti-epileptic drug exposure during the fetal period may have cognitive problems at 6 years of age. Children with a history of exposure to sodium valproate had an IQ (mean IQ 99) that was significantly lower than that of other antiepileptic drug exposure groups (carbazepine group IQ 105, phenytoin group IQ 106), and poor language skills and memory. The amount of sodium valproate was negatively correlated with IQ, language ability, memory and executive ability, and there was no corresponding relationship between other antiepileptic drugs. The IQ of children who took folic acid before pregnancy was slightly higher than that of children who did not take folic acid (108 and 102).


Anti-epileptic drug-related birth defects with genetic susceptibility


First- or second-degree relatives of pregnant women with a family history of birth defects, the risk of fetal birth defects increased by 41.8%, and the risk of no family history increased by 8.6%. If you take anti-epileptic drugs in multiple pregnancies, the risk of fetal birth defects will increase accordingly. Among them, if the drug contains sodium valproate, the risk of fetal birth defects is higher.


Clinical and laboratory evidence suggests that anti-epileptic drug leakage during pregnancy can adversely affect the fetus, causing birth defects, cognitive, behavioral, and motor disorders. Specific drugs, doses are associated with risk, especially high doses of sodium valproate and sodium phenobarbital. In addition, genetic susceptibility is also an important factor. These influencing factors should be weighed against uncontrolled seizures to select anti-epileptic treatment strategies for women in pregnancy.