Details:

Alternative Title:
Ann Epidemiol
Personal Author:
WERLER, MARTHA M. ; AHRENS, KATHERINE A. ; BOSCO, JACLYN L.F. ; MITCHELL, ALLEN A. ; ANDERKA, MARLENE T. ; ... More +
WERLER, MARTHA M. ; AHRENS, KATHERINE A. ; BOSCO, JACLYN L.F. ; MITCHELL, ALLEN A. ; ANDERKA, MARLENE T. ; GILBOA, SUZANNE M. ; HOLMES, LEWIS B. ; Less -
Corporate Authors:
THE NATIONAL BIRTH DEFECTS PREVENTION STUDY ;
Description:
PURPOSE To evaluate use of specific antiepileptic drugs (AEDs) in pregnancy in relation to specific birth defects. METHODS Using data from the National Birth Defects Prevention Study, we assessed use of AEDs and the risk of neural tube defects (NTDs), oral clefts (OCs), heart defects (HDs), hypospadias, and other major birth defects, taking specific agent, timing, and indication into consideration. RESULTS Drug-specific increased risks were observed for valproic acid in relation to NTDs [adjusted odds ratio (aOR), 9.7;, 95% confidence interval (CI), 3.4–27.5], OCs (aOR, 4.4; 95% CI, 1.6–12.2), HDs (aOR, 2.0; 95% CI, 0.78–5.3), and hypospadias (aOR. 2.4; 95% CI, 0.62–9.0), and for carbamazapine in relation to NTDs (aOR, 5.0; 95% CI, 1.9–12.7). Epilepsy history without AED use did not seem to increase risk. CONCLUSIONS Valproic acid, which current guidelines suggest should be avoided in pregnancy, was most notable in terms of strength and breadth of its associations. Carbamazapine was associated with NTDs, even after controlling for folic acid use. Sample sizes were still too small to adequately assess risks of less commonly used AEDs, but our findings support further study to identify lower risk options for pregnant women.
Subject:
[+]
Abnormalities, Drug-Induced
Adolescent
Adult
Anticonvulsants
Article
Carbamazepine
Epilepsy
Female
Humans
Male
Pregnancy Complications
Valproic Acid
Young Adult

Source:
Ann Epidemiol. 21(11):842-850. ;
Pubmed ID:
21982488
Pubmed Central ID:
PMC4816042
Document Type:
Journal Article ;
Funding:
T32 HD052458/HD/NICHD NIH HHS/United States ; U01 DD000493/DD/NCBDD CDC HHS/United States ; U01DD000493/DD/NCBDD CDC HHS/United States ;
T32 HD052458/HD/NICHD NIH HHS/United States ; U01 DD000493/DD/NCBDD CDC HHS/United States ; U01DD000493/DD/NCBDD CDC HHS/United States ; Less -
Place as Subject:
United States ;
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:da821162fdc104a412578062494ccfaff5f932e8305e70a29a31fab4361d7683
File Type:

Supporting Files

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