Newer-Generation Antiepileptic Drugs and the Risk of Major Birth Defects

Abstract

Among live-born infants in Denmark, first-trimester exposure to lamotrigine, oxcarbazepine, topiramate, gabapentin, or levetiracetam compared with no exposure was not associated with an increased risk of major birth defects.

Pregnancy Outcomes Following In Utero Exposure to Lamotrigine: A Systematic Review and Meta-Analysis

“…Observational studies investigating the association between lamotrigine exposure during pregnancy and risk for congenital malformations have yielded conflicting results thus far [21][22][23][24]. Furthermore, some of the studies were based on different types of pregnancy registries with voluntary enrollment, which often lacked the power to demonstrate statistical significance and repeatedly lacked valid comparison groups.…”

Potential maternal symptomatic benefit of gabapentin and review of its safety in pregnancy

“…Molgaard-Nielsen et al [25]: one MCM (congenital heart disease) among 59 monotherapy exposures. 75% of cohort had epilepsy.…”

Associations between particular types of fetal malformation and antiepileptic drug exposurein utero

“…With the larger population exposed to the drug in mono-and polytherapy, statistically significant associations emerged, and the association in relation to hypospadias appeared to be dose-related. Some previous studies have failed to find statistically significant evidence of TPM teratogenesis overall (14,15). Hunt et al (16), in an analysis of the UK Pregnancy Register data, also found statistically significant evidence that TPM exposure was associated with increased fetal malformation rates, but their rates for oral clefts (2.2%) did not quite reach a P < 0.05 value [a point brought out by Fountain (17)].…”