Anticonvulsants in pregnancy
Article Abstract:
About 1 in every 200 pregnancies occurs in a woman who has epilepsy or seizure disorder; many of these women must take anticonvulsants to prevent seizure recurrence. This article reviews medical aspects and the outcome of pregnancies in epileptic women. Seizure incidence may change, as can drug effectiveness, due to changes in how the drug is metabolized by the body. Only minor complications for the mother are found in these pregnancies. However, the perinatal (at birth) mortality rate for newborns is higher, due to increased incidence of hemorrhages and congenital abnormalities. This is because most anticonvulsant medications alter the availability or effect of blood clotting factors. The most common congenital abnormality is cleft lip and palate. Other structural problems and developmental delays have also been reported. It appears that all anticonvulsants may have teratogenic effects (potential to cause birth defects), some more severe than others. Many problems have been reported with troxidone (trimethadione) and paramethadione, and with phenytoin. Sodium valproate has been specifically related to neural tube defects, of which spina bifida is one. Carbamazepine, previously considered safe, has been associated with facial defects and developmental delay similar to that seen with other anticonvulsant drugs. Benzodiazepines, when taken regularly, probably also result in similar problems. High dosage and multiple drug use are more strongly associated with occurrence of abnormalities. The issue of whether antiepileptic medication or severe epilepsy requiring medication are more strongly related to deformities has not been well studied, but the link between medication and deformity seems likely. The mechanism underlying this is unclear. Breastfeeding is not contraindicated by epilepsy or by treatment with anticonvulsants. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Archives of Disease in Childhood
Subject: Health
ISSN: 0003-9888
Year: 1991
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Parental agricultural work and selected congenital malformations
Article Abstract:
Researchers conducted a case-control study in Spain to examine the link between occupational exposure to pesticides and the occurrence of congenital malformations. They selected 261 cases and 261 controls from infants born in public hospitals between 1993 and 1994. In addition, they gathered information on occupational exposures from parents. Maternal exposure before conception and the first trimester of pregnancy did carry risks. Paternal exposure did not increase the risk.
Publication Name: American Journal of Epidemiology
Subject: Health
ISSN: 0002-9262
Year: 1999
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