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Newer antiepileptic drugs not linked to birth defects

By Alisdair Stirling

Use of newer antiepileptic agents during the first trimester of pregnancy is not linked to risks of major birth defects, Danish research suggests.

In a study of 837,000 live births between 1996 and 2008, researchers found 2.4% of births in women not exposed to antiepileptics were diagnosed with major birth defects, as defined by the European surveillance of congenital anomalies classification system.

Among the 1,532 pregnancies exposed to lamotrigine, oxcarbazepine, topiramate, gabapentin or levetiracetam during the first trimester, 3.2% of infants were diagnosed with a major birth defect – a statistically insignificant difference in the incidence in non antiepileptic-exposed women.

Birth defects were diagnosed in 3.7% of women exposed to lamotrigine during the first trimester, in 2.8% exposed to oxcarbazepine and 4.6% exposed to topiramate.

Gabapentin and levetiracetam exposure during the first trimester was uncommon, with only one infant diagnosed with birth defects.

Study leader Ditte Molgaard-Nielsen an epidemiologist at the Statens Serum Institut in Copenhagen, added: ‘The prevalence odds ratios for any major birth defects after exposure to any newer-generation antiepileptic drugs during the first trimester were not statistically different for mothers with epilepsy, mood affective disorder or migraine, or without a diagnosis.'

JAMA. 2011;305(19)1996-2002

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