Intrauterine growth in the offspring of epileptic mothers

Abstract

The present paper concerns the fetal growth of 315 newborns of epileptic mothers prospectively followed from the beginning of pregnancy. In comparison with Italian standards, neonatal weight, length and head circumference at birth were below the 10th percentile in respectively 15.7%, 1.1% and 19.2% of the newborns. Weight at birth was above the 90th percentile in 8 cases. Observed frequencies were significantly higher than expected frequencies for both weight and head circumference. The percentage of newborns with a small head circumference increased significantly according to the number of drugs taken by the mother during the first three months of pregnancy: 7.1% with no drug, 16.8% with one drug, 23.6% with two drugs and 50% with three drugs. A statistically significant correlation was found between gestational age-adjusted head circumference and drug-level scores during the first trimester. Head circumferences below the 10th percentile were fewer among newborns treated with CBZ than among newborns treated with either PB or VPA.

Epilepsy and pregnancy: effect of antiepileptic drugs and lifestyle on birthweight

“…There have been conflicting results in previous studies regarding epilepsy and preterm delivery. Some studies have reported an increased risk 9,10 and others have not 11–14 . Most studies of epilepsy and pregnancy outcome have failed to report on duration of gestation, and methods of estimating gestational age have been described in few studies.…”

The frequency of neonatal morbidity after exposure to antiepileptic drugs in utero

“…Carbamazepine and valproate have been linked to neural-tube defects, whereas phenobarbital, phenytoin and primidone have been linked to congenital heart defects, cleft lip, and cleft palate [12]. Some studies found a tendency to growth retardation [13] and some found no sign of retarded growth [14][15][16]. Microcephaly has been reported in neonates with intrauterine exposure to AEDs.…”

Antiepileptic Drugs in Pregnancy: Options for the Prevention of Congenital Abnormalities

“…A number of studies showed various degrees of growth impairment, either on all growth parameters, and/or lower Apgar scores [28, 32, 38, 39], or only on one of these parameters [30, 34, 36]. Some studies showed growth impairment to be associated with specific AEDs, such as valproate [25, 33, 41], carbamazepine [27]and phenobarbital [35, 41]. Other studies did not find any association between AEDs and growth impairment or adverse perinatal outcome [8, 26, 31, 40].…”