Drug Politerapi Antiepileptik During Pregnancy and Risk of Fetal Malformations

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During pregnancy, drug politerapi antiepileptik (OAE), which includes valproate sustained a risk of malformations in the fetus than politerapi without this drug. This finding is the result of the study dr. Lewis Holmes and colleagues, from MassGeneral Hospital for Children in Boston, which was published online in mid June 2011 in the Archives of Neurology. During this time, it is known that women who consume more than one type of OAE during pregnancy have a higher risk of having infants with severe congenital malformations, compared to pregnant women who use only one type of OAE. Studies conducted dr. Holmes and his team will further strengthen the evidence of close links politerapi OAE use by pregnant women with the risk of malformations in the fetus. The study, named the North American AED Registry revealed that the risk of malformations increased significantly in
fetuses exposed politerapi consisting of carbamazepine or lamotrigine plus valproate, but not the case when carbamazepine or lamotrigine in combination with other OAE.
The study included 6857 women who ate the OAE during a certain time period during pregnancy and 441 pregnant women who are not using the OAE. The study took place from February 1997 until June 2010. Based on the investigators' analysis, the risk of malformation was revealed by 1.9% among 1441 infants exposed to lamotrigine monotherapy during in utero. However, among 505 infants exposed in utero during politerapi lamotrigine, the risk of malformations was recorded at 9.1% for the combination of valproate plus lamotrigine (odds ratio, 5.0) versus 2.9% for the combination of lamotrigine plus other OAE (odds ratio 1, 5). On the other hand, measured the risk of malformations of 2.9% of 1012 infants exposed to carbamazepine monotherapy. A total of 365 infants in whom the risk of malformations reported by 15.4% for the combination of valproate plus carbamazepine (odds ratio, 6.2) versus 2.5% for the combination of carbamazepine plus other OAE (odds ratio 0.8).
Confounding factors, such as the use of vitamins during the conception, smoking, drinking alcohol, and chronic maternal disease, not associated with these outcomes. The research team also underlined that their findings are in line with previous research results published by the UK Epilepsy and Pregnancy Register and the International lamotrigine Pregnancy Registry. "Our findings, together with two earlier findings turned out to support each other, suggesting that the risk of malformations in the fetus varies according to specific OAE used in politerapi," dr. Holmes concluded. Furthermore, dr. Holmes warned that valproate should not be prescribed to pregnant women, either as monotherapy or politerapi.