Antiepileptic medication in pregnancy: late effects on the children's central nervous system development

Article Abstract:

Although research results suggest that antiepileptic medication is teratogenic (causes birth defects), in practice it is difficult to separate drug effects from effects due to maternal seizures themselves or to social and economic risk factors, also elevated among epileptic women. A study was carried out to disentangle these effects, using 61 children selected from a larger sample born to 132 epileptic mothers. None of these women had seizures during the pregnancy. The mothers had taken phenobarbital only (13 subjects); carbamazepine only (12); both drugs (12); or no antiepileptic drugs at all (24) during pregnancy; a matched control group was also selected. The study was long-term; the current report concerns 57 children between the ages of 6 and 13. The children underwent neurologic examination (and were scored as either normal, presence of minor neurologic dysfunctions, or abnormal); testing for reading, spelling, and arithmetic; and behavioral evaluation. Results showed no differences between the children of epileptic mothers and controls in the rate of minor neurologic dysfunction. However, the group born to mothers from the phenobarbital-only group had a higher proportion of poor performers on the arithmetic and spelling tests. No differences were found for other measures of cognitive development or behavior. Physical measurements revealed normal weight and height for all children, but skull circumferences for phenobarbital-only children were smaller (this may be linked to an adverse effect on cognitive development). A greater proportion of the children of epileptic mothers (including those whose mothers had not taken an antiepileptic drug) than controls had minor physical abnormalities (abnormality of posture, muscle tone, or coordination). Thus both major and minor birth defects seem to be associated more closely with the maternal epilepsy than the medication taken during pregnancy. But the results also suggest that phenobarbital may be a potential teratogen; the issue deserves further investigation. (Consumer Summary produced by Reliance Medical Information, Inc.)

Fetus, Drug therapy, Epilepsy, Pregnancy, Child development, Epilepsy in pregnancy

---

Supplementation of vitamin K in pregnant women receiving anticonvulsant therapy prevents neonatal vitamin K deficiency

Article Abstract:

Pregnant women on anticonvulsant drugs may reduce their baby's risk of vitamin K deficiency by taking a vitamin K supplement. Infants exposed to anticonvulsant drugs in the uterus have an increased risk of vitamin K deficiency. Vitamin K deficiency can cause bleeding disorders, especially in newborns, because their blood clotting ability is not fully developed. Of 36 epileptic pregnant women taking anticonvulsant drugs, 16 took vitamin K supplements and 20, who served as the controls, did not. Levels of protein induced by vitamin K absence for factor II (PIVKA-II) were measured in blood samples from the umbilical cord. PIVKA-II was not detected in any of the samples from the group taking vitamin K supplements. However, 13 of 20 samples from the control group were positive for PIVKA-II. Vitamin K was detected in all cord samples from the group taking vitamin K supplements but was only detected in one cord sample from the control group.

Prevention, Hemorrhagic diseases, Hemorrhagic disorders

---

Increased incidence of neonatal vitamin K deficiency resulting from maternal anticonvulsant therapy

Article Abstract:

Infants exposed to anticonvulsant drugs in the uterus appear to have an increased risk of vitamin K deficiency. Vitamin K deficiency can result in hemorrhagic disease of the newborn, which is a bleeding disorder caused by a reduction in blood coagulation factors. Detection of protein induced by vitamin K absence of factor II (PIVKA-II) is the standard test for vitamin K deficiency. Levels of vitamin K and PIVKA-II were measured in 24 pregnant women who took anticonvulsant drugs and 25 healthy pregnant women. PIVKA-II was detected in 54% of the umbilical cord blood samples from the group taking anticonvulsants compared with 20% of the samples from the other group. Vitamin K could not be detected in most of the umbilical cord samples from either group. Vitamin K levels were lower in mothers from both groups following delivery, but PIVKA-II was only detected in two of the mothers, both of whom took anticonvulsant drugs.

Risk factors

Similar abstracts:

• Abstracts: Smoking during pregnancy and lactation and its effects on breast-milk volume. Flavin composition of human milk
• Abstracts: Borrelia burgdorferi in the central nervous system: experimental and clinical evidence for early invasion. A specific and sensitive assay for the Lyme disease spirochete Borrelia burgdorferi using the polymerase chain reaction
• Abstracts: Successful antepartum treatment of listeriosis. Preliminary results of 5% immiquimod cream in the primary treatment of vulva intraepithelial neoplasia grade 2/3
• Abstracts: Association between hypothermia and mortality rate of premature infants - revisited. Neonatal survival and disability rate at age 18 months for infants born between 23 and 28 weeks of gestation

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.