April 19, 2001 – Doctors were already aware that antiepileptics (also called anticonvulsants) prescribed to women with epilepsy during pregnancy could cause birth defects; but, it was believed, the disease itself was largely responsible for these problems. However, an article from New England Journal of Medicine asserts that antiepileptics are the only ones involved, since women with epilepsy who do not take medication have no more risk than the normal population of giving birth to a child with a malformation.
Dr. Louis Holmes and his colleagues studied 316 babies who had been exposed to anticonvulsants while they were still in the womb, as well as 98 women with epilepsy who had stopped the medication during their pregnancy. Of the 223 babies whose mothers took one of these drugs, 4% were born with major deformities; of 93 babies whose mothers took two or more of these drugs, 8.6% were born disabled. On the other hand, none of the mothers who stopped their medication during pregnancy gave birth to a baby with a malformation (in the control group of 508 “normal” pregnancies, 1.8% of the babies were born disabled).
In particular, this study reveals that taking two drugs simultaneously during pregnancy further compromises the health of the fetus. However, the family of anticonvulsants includes several products, but none can completely cure the disease, which prompts doctors to prescribe more than one product to those suffering from a severe form of the disease. In addition, doctors have long considered phenobarbital as the least harmful of them, often suggesting to their patients to opt for it when they become pregnant. “This is bad practice,” says Dr. Martha Morrel, head of the epilepsy center at Columbia University Medical School. She believes switching from one drug to another during pregnancy would be as bad as taking two drugs. Dr. Holmes’ research has shown that phenobarbital is just as harmful as any other when it comes to birth defects.
Responding to the article, experts continue to claim that epilepsy itself may be responsible for some of the birth defects. They also mentioned that women who do not take antiepileptics during pregnancy are often less severely affected than those who take them. Finally, it was recalled that, for women suffering from epileptic seizures, the fact of abruptly stopping the medication at the beginning of a pregnancy presented a real danger.
HealthPassport.net
Holmes LB, Harvey EA, Coull BA, Huntington KB, Khoshbin S, Hayes AM, Ryan LM. The teratogenicity of anticonvulsant drugs. N Engl J Med. 2001 Apr 12; 344 (15): 1132-8.
According to Associated Press, April 11, 2001