Birth defect risk with newer antiepileptic drugs

January 01, 0001

Birth defect risk with newer antiepileptic drugs

Some older anti-epileptic carry significant risk of birth defects. These Danish researchers examined the rates of major birth defects with first trimester exposure to newer-generation antiepileptic. They performed a population-based cohort study of 837 795 live-born infants in Denmark. Individual-level information on antiepileptic drugs prescription, birth defects and possible confounders were garnered from nationwide health registries.

The researchers found: "Of the 1532 infants exposed to lamotrigine, oxcarbazepine, topiramate, gabapentin, or levetiracetam during the first trimester, 49 were diagnosed with a major birth defect compared with 19 911 of the 836 263 who were not exposed to an antiepileptic drug (3.2% vs 2.4%, respectively; adjusted POR [APOR

The researchers concluded: "Among live-born infants in Denmark, first-trimester exposure to lamotrigine, oxcarbazepine, topiramate, gabapentin, or levetiracetam compared with no exposure was not associated with an increased risk of major birth defects."

This large Danish study finds no evidence of increased risk of major birth defects with first-trimester exposure to a variety of newer generation antiepileptic medications.

For the full abstract, click here.

JAMA 305(19):1996-2002, 18 May 2011 © 2011 American Medical Association
Newer-Generation Antiepileptic Drugs and the Risk of Major Birth Defects. Mølgaard-Nielsen and Anders Hviid.

Category: N. Neurological, W. Pregnancy, Family Planning. Keywords: birth defects, antiepileptics, lamotrigine, oxcarbazepine, topiramate, cohort study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 10 June 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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