A study shows an increased risk of developing motor disorders and autistic traits in children exposed in utero to antiepileptic drugs.
Each year in France, 5,000 babies are born to mothers with epilepsy. These pregnancies go uncomplicated in 92 to 96% of cases. However, the pregnancies of these women are considered at risk by the medical profession. Precise measures are usually put in place to avoid complications for both the baby and the expectant mother. Monitoring, which notably involves adapting the antiepileptic treatment. And for good reason, several studies have already shown that their absorption during pregnancy can disrupt the development of the fetus. More specifically, certain drugs, for example, increase the risk of major birth defects. Other studies also show that the verbal IQ of these children is reduced.
Moreover, may a new potential risk of exposure to these treatments during pregnancy have just been identified? A Norwegian study published in the journal Epilepsia highlights an increased risk of developing motor disorders, as well as autistic traits in children exposed in utero. This work was carried out using data from 333 children exposed during pregnancy to different antiepileptics (valproate, lamotrigine or carbamazepine) between 1999 and 2008 and then observed at the ages of 18 and 36 months. For epilepsy specialists, these results add another stone to research aimed at improving the management of pregnancies in women with epilepsy. However, obtained from the observation of too small numbers, these data should in no case panic the patients. They do, however, remind us that medication during pregnancy is not trivial.
Listen to Prof. Franck Semah, President of the Scientific Council of the Foundation for research on epilepsy: ” Women with epilepsy should not come to their doctor saying I am pregnant, what am I doing? Currently, faced with a woman with epilepsy, from the age of 15, we take the time to choose the most suitable treatment in the event of pregnancy.
Nevertheless, the authors will continue the analysis of this register and thus increase the number of babies exposed in utero to the antiepileptics monitored. “The results that this team will have in ¾ years will be more interesting. But for the moment, it is insufficient to say that one chooses one or another drug more to avoid motor disorders, for example, ”specifies Franck Semah, who is also head of the Functional Imaging department at the Lille CHRU. However, over the past decade, the management of these particular pregnancies has improved markedly. Doctors are now able to rule out or advise this or that treatment in order to limit the risk of malformations in babies conceived by mothers with epilepsy under treatment. Specialists have really realized that for everything to go well in women with epilepsy during pregnancy, everything must have been well anticipated.
Listen to Prof. Franck Semah : ” Our practices no longer have anything to do with what we did 10 years ago. Now we have figures which specify that drug A entails less risk than drug B ”.
Anyway, the experts insist. Stopping her antiepileptic medication during pregnancy can be much more dangerous for the baby than continuing to take it. According to specialists, the percentages of increased risks associated with taking these treatments are really minimal, compared to the real dangers caused by the occurrence of epileptic seizures during pregnancy. Indeed, the risk of resumption or increase in seizures and their consequences for the mother, such as falls that can cause the death of the unborn baby, is much higher than the risk of fetal developmental disorders caused by the drug exposure.
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