Antiseizure medications use during pregnancy and congenital malformations: A retrospective study in Saudi Arabia

Abstract

Aim To evaluate the incidence of congenital malformations in children exposed prenatally to antiseizure medications (ASMs), to assess other perinatal and fetal complications, and to determine the potential predictors for these complications. Method A retrospective review of pregnancy outcomes of women with epilepsy. Patients were followed up at the King Faisal Specialist Hospital and Research Centre, Riyadh and Jeddah, Saudi Arabia, between Dec 1993 and Oct 2020. Results Of 162 pregnancies included, 10 (6.17%) congenital malformations were observed, 6.82% in ASM-exposed babies versus 3.33% in babies of epilepsy-untreated mothers (P = 0.69). The overall incidence of perinatal and fetal complications was 53%; most frequent were low birth weight (24%), preterm birth (19%), transfer to neonatal intensive care unit (18%) and abortion (8%). These complications were higher in the untreated group (66.67%) than in the ASM group (50%). The use of other non-antiseizure medications during pregnancy was the only factor that significantly increased the risk of complications. Conclusion Prenatal exposure to ASMs was associated with increased risk of congenital malformations. However, overall perinatal and fetal complications were higher in the untreated group than in the ASM group, which could be explained by maternal seizures. Therefore, taking ASMs to control epilepsy and prevent perinatal complications may outweigh the risks of teratogenicity.

Genetic Counseling in a Couple with Primary Infertility

“…26 Anti-epileptic drugs (AEDs) or anti-seizure medication have been linked to secondary endocrine diseases through increasing teratogenic risk and unfavorable effects on peripheral endocrine glands, which affect hormone metabolism and protein binding. 26,27 Long-term use of carbamazepine medication is linked to teratogenic effects, decreased sexual drive, and irregular menstrual cycles. 26 Endometriosis and adenomyosis are closely related diseases with different conditions.…”