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Taking epilepsy drugs in pregnancy may lead to birth of babies with defects

Taking epilepsy drugs in pregnancy may lead to birth of babies with defects
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Women who take valproic acid have 19 times greater risk of having a baby with spina bifida as compared with women who do not take epilepsy drugs.

Written by ANI |Published : June 17, 2019 8:47 AM IST

Drugs prescribed to control epilepsy in pregnant women with migraine, pain and bipolar disorder are likely to deliver babies with birth defects, according to a new study. The study lays focus on the drugs -- valproic acid and topiramate. The birth defects include spina bifida and cleft lip.

For the study, researchers used data to identify pregnancies that resulted in live births between January 2011 and March 2015. From the 1,886,825 pregnancies reported during those years, the researchers looked for the mothers' use of 10 anti-epileptic seizure drugs before and after conception.

Researchers further looked for 23 birth defects in the children delivered by these women. The findings indicated that 8,794 women were prescribed a single anti-epileptic drug.

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Women who were prescribed with valproic acid (10.4 pc of the group of pregnant women prescribed anti-epileptic medication) had 19 times greater risk of having a baby with spina bifida as compared with women who did not take an epilepsy drug.

Among the 913 women prescribed valproic acid, six babies (0.66 pc) had spina bifida, as compared with 616 babies (0.03 pc) born to women not taking an epilepsy drug. The drug also increased the risk of seven other birth defects, including cleft palate and four types of heart defects.

On the other hand, women prescribed topiramate (5.9 pc) had a seven times greater risk of having a baby with cleft lip (with or without cleft palate), the study has indicated. Among the 517 women prescribed topiramate, three babies (0.60 pc) had cleft lip, compared with 1,637 babies (0.09 pc) born to women not taking an epilepsy drug.

"The new study confirms other large-scale studies where similar findings were found. It reinforces the risks associated with these particular two medications," CNN quoted Dr David Ficker, chairman-elect of the professional advisory board of the Epilepsy Foundation, as saying.

"I also know that there are some women with difficult-to-control epilepsy that valproic acid may be the only medication that might be effective for them. All these different medicines have different ways of working in the brain, and they're not necessarily completely interchangeable," said Dr David.

"Most notable, valproic acid use during pregnancy has been associated with a higher risk for lower IQ, autism and autism spectrum disorder, and the need for special education in the children who were exposed during pregnancy. Topiramate has also been associated with increased risk for low birth weight," said Dr Page Pennell, president, American Epilepsy Society.

"A planned pregnancy allows the health care provider and the woman to decide on the best plan for her individually to lower fetal risk while keeping her seizures under optimal control," concluded Dr Pennell.