Use of Antiepileptic Medications in Pregnancy in Relation to Risks of Birth Defects

Details

• Alternative Title:
  Ann Epidemiol
• Personal Author:
  WERLER, MARTHA M. ; AHRENS, KATHERINE A. ; BOSCO, JACLYN L.F. ; MITCHELL, ALLEN A. ; ANDERKA, MARLENE T. ; GILBOA, SUZANNE M. ; HOLMES, LEWIS B.
• 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.
• Subjects:
  • Abnormalities, Drug-Induced
  • Adolescent
  • Adult
  • Anticonvulsants
  • Carbamazepine
  • Epilepsy
  • Female
  • Humans
  • Male
  • Pregnancy Complications
  More +
• 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
• Place as Subject:
  United States
• Volume:
  21
• Issue:
  11
• Download URL:
  https://stacks.cdc.gov/view/cdc/38760/cdc_38760_DS1.pdf
• File Type:
  [PDF - 334.78 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:da821162fdc104a412578062494ccfaff5f932e8305e70a29a31fab4361d7683