Fetal Malformations and Antiepileptic Drugs

Hill, Reba M.

doi:10.1001/archpedi.1976.02120100013002

Cited by 21 publications

(5 citation statements)

References 16 publications

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“…In our experience, children excessively exposed to BZD in utero, have a pattern of craniofacial anomalies (23), which was also found in 5 of our 17 BZD children exposed to therapeutic doses of BZD. This finding indicates that BZDs have a teratogenic effect, and this is in agreement with the accepted occurrence of dysmorphic features seen in children after prenatal exposure to alcohol (4) and anticonvulsant drugs (14,16). Lindahl and Michelson (26) found an association between prenatal insults in form of minor congenital anomalies and neurodevelopmental disturbances.…”

Section: Laegreid Et Alsupporting

confidence: 85%

Neurodevelopment in Late Infancy After Prenatal Exposure to Benzodiazepines - A Prospective Study*

1992

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Growth and neurodevelopment at 6, 10 and 18 months of age have been studied prospectively and longitudinally in a series of 17 children born to mothers who used benzodiazepines (BZD) in therapeutic doses as their only psychotropic drug throughout pregnancy. The results were compared with a group of 29 children born to mothers without any known use of psychotropic drugs. The BZD-exposed children caught up their low mean birth-weight, at an early stage, whereas the slightly decreased head circumference at birth remained at the same low level. In five infants, a pattern of craniofacial anomalies was found. Deviating neurodevelopmental and clinical symptoms and signs were common. The gross motor development was retarded at 6 and 10 months, but was nearly normal at 18 months. Impaired fine motor functions were found on all follow-up occasions. At 18 months, the most prominent finding was a delayed development of pincer grasp. The BZD-exposed children showed deviations in muscle tone and pattern of movements more frequently than children in the reference group. The study suggests that the use of BZD in therapeutic doses throughout pregnancy can have negative effects on the development of children up to 18 months of age. The long-term hazards cannot be evaluated from these results. A further follow-up at early school age is needed and is in progress.

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Section: Laegreid Et Alsupporting

confidence: 85%

Neurodevelopment in Late Infancy After Prenatal Exposure to Benzodiazepines - A Prospective Study*

1992

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“…The infants' unusually severe or bizarre abnormalities therefore could be explained by the potentiated teratogenesis by drugs a n d alcohol acting together. This explanation seems acceptable when the drugs are anticonvulsants, since fetal a n t i c o n v u l s a n t a n d f e t a l a l c o h o l syndromes have many features in common (Hill 1976 (Robinson 1977). Severe malnutrition (Stein and Susser 1976) and low levels of folate and other vitamins during the first trimester (Smithells et al 1976) have been suggested as risk factors for the development of neural-tube defects.…”

Section: Discussionmentioning

confidence: 99%

Alcohol, Other Drugs and the Fetus

Poskitt¹,

Hensey²,

Smith³

1982

Develop Med Child Neuro

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SUMMARY The congenital abnormalities in five infants born to mothers who drank excessive amounts of alcohol during pregnancy are described. Four of the five mothers also took other drugs, known to potentiate the effects of alcohol in the adult. It is suggested that the severity of the abnormality in some of these infants was due to potentiation of the effects of alcohol by associated drugs. The poor prospect for normal family life among the children of alcoholic women seems to have improved little since it was discussed in a paper from Liverpool in 1899. RÉSUMÉ Les anomalies congénitales de cinq nourrissons nés de mères ayant consommé des quantités excessives d'alcool pendant la grossesse sont décrites. Quatre des cinq mères avaient pris en outre durant la grossesse des médications connues pour potentialiser les effects de l'alcool chez l'adulte. On peut penser que la gravité des anomalies chez certains des nourrissons est liée à la potentialisation des effects de l'alcool par des médications asociées. Le faible espoir d'une vie familiale normale chez les enfants de femme alcoolique ne semble guère s'etre amélioré depuis qu'il a été discuté dans un article de Liverpool en 1899. ZUSAMMENFASSUNG Bei fünf Säuglingen, deren Mütter in der Schwangerschaft excessive Mengen Alkohol tranken, werden Mißbildungen beschrieben. Vier der Mütter nahmen in der Schwangerschaft zusätzlich andere Drogen, die die Wirkung des Alkohols beim Erwachsenen verstärken. Man nimmt an, daß die Schwere der Mißbildungen bei einigen dieser Kinder durch die Potenzierung der Alkoholwirkung durch zusätzliche Drogen hervorgerufen wurde. Die schlechte Prognose für ein normales Familienleben bei Kindern alkoholsüchtiger Mütter hat sich seit 1899, als das Problem in einer Zeitschrift von Liverpool diskutiert wurde, wenig geändert. RESUMEN Se describen las anomalias congénitas de cuatro niños nacidos de madres que bebian cantidades excesivas de alcohol durante el embarazo. Cuatro de las cinco madres tomaban fármacos, cuya acción se sabe que potencia los efectos del alcohol en el adulto, durante la gestación. Se sugiere que la gravedad de las anomalias en algunos de estos ninños se debia a la potenciación de los efectos del alcohol por fármacos asociados. La pobre perspectiva de una vida familiar normal entre los niños de mujeres alcohólicas, no parece haber mejotado mucho desde que el tema fue discutido en una communicación de Liverpool en 1899.

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“…Pierce and West showed that the degree of alcoholinduced microencephaly was dependent on the pattern in which alcohol was administered. ' 7 3~1 7 4 In these studies, alcohol was administered to rat neonates at a time corresponding to their brain growth spurt period (human third trimester equivalent). Brain growth was found to be significantly retarded when alcohol was administered in a condensed fashion, such that blood alcohol levels cycled with high peaks (270.2 mg/dl).…”

Section: Alcohol Teratogenesis: Critical Periods and Threshold Dosesmentioning

confidence: 99%