Teratogenic Effect of Anticonvulsants

The Teratogenic Risk of Antiepileptic Drugs

“…Loughnan et al (1973) described a different syndrome of skeletal anomalies in 7 children of mothers who took DPH and phenobarbital during pregnancy: "The basic abnormality was a variable degree of hypopIasia and irregular ossification of the distal phalanges, producing short narrow and misshaped ends to both the fingers and toes." H i l l et al (1973) observed "a characteristic clustering of malformations," which was similar to the pattern described by Speidel and Meadow (1972) as well as to that described by Loughnan et al (1973). The 3 infants reported by Hill et al (1973) had been born to one mother who received phenobarbital, DPH, and primidone during the pregnancies.…”

“…This was done either by selecting the mother whose case sheet number was nearest to that of the epileptic mother (Watson and Spellacy, 1971;Speidel and Meadow, 1972) or by collecting all hospital births during a certain time (Elshove and Van Eck, 1971;South, 1972;Monson et al, 1973). In still other studies, all births reported by general practitioners (Kuenssberg and Knox, 1973) or all births in a geographically defined population (Lowe, 1973) served as control groups.…”

“…Studies using serum concentration of DPH during pregnancy and at the time of birth with data on child and mother are few (Baughman and Randinitis, 1970;Mirkin, 1971a,b;Loughnan et al, 1973). According to Mirkin (1971a,b), mother and child have identical serum concentrations at birth.…”

Multi‐institutional Study on the Teratogenicity and Fetal Toxicity of Antiepileptic Drugs: A Report of a Collaborative Study Group in Japan

“…An incidence of 25% in a medicated group was reported by Hill (1974), and rates in excess of 10% have been found by some other authors (Elshove and van Eck, 1971; Kuenssberg and Knox, 1973; Barry and Danks, 1974;Shapiro et al, 1976). An incidence of 25% in a medicated group was reported by Hill (1974), and rates in excess of 10% have been found by some other authors (Elshove and van Eck, 1971; Kuenssberg and Knox, 1973; Barry and Danks, 1974;Shapiro et al, 1976).…”

Factors Determining the Teratogenicity of Drugs

“…Most noteworthy in this group are the anticonvulsant drugs used in the treatment of epilepsy (15,16). Since the earlier reviews, a spate of additional reports have left little doubt that a higher percentage of defective infants are born to epileptic women on anticonvulsant therapy during the first trimester of pregnancy than would be expected from births in the general population (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31). Several important questions must be answered, however, before this effect can be attributed to the drugs used.…”