engleski

Antiepileptic drugs during pregnancy: retrospective and prospective studies

Usage of antiepileptic drugs (AEDs) in women during pregnancy is known as a risk factor for an increased frequency of certain birth defects. A number of retrospective and very few prospective studies have been conducted to evaluate possible complications of the AEDs therapy during pregnancy and delivery and the effects of drugs on the foetus. The aim of our work is to present characteristics of retrospective and prospective studies that we have performed in pregnant women with epilepsy in the University Hospital Centre Rijeka, Croatia. In the retrospective study during the nine year period ( 1993- 2000) we have examined data from 129 pregnant women with epilepsy. Prospective analysis is according to the European Antiepileptic Drugs and Pregnancy Registry (EURAP) and we are following up 17 pregnancies and we are including new ones. During a 9-year period 164 children were born and 23 miscarriages before delivery occurred in women with epilepsy diagnosis in medical history. AEDs were used in 69% of patients and as monotherapy in 76% of them. The most frequently used AEDs were CBZ (32.5 96), VPA (31%), PB (27.8%). No specific teratogenic effects were observed. According to EURAP protocol eight children were born with no malformations. Because no major birth defects connected with AEDs usage were observed in our retrospective study, we might presume that the potential risk is very low. According to the results of our retrospective study it is obvious that the answer to the unsolved questions in this field, such as real impact of AEDs (teratogenicity), is only possible through population oriented pregnancy registries as EURAP.

epilepsy ; antiepileptic drugs ; pregnancy ; teratogenicity ; EURAP ; retrospective study ; prospective study

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