Foetal malformations and seizure control: 52 months data of the Australian Pregnancy Registry

Vajda, F. J. E., Hitchcock, A., Graham, J., Solinas, C., OBrien, T. J., Lander, C. M. and Eadie, M. J. (2006) Foetal malformations and seizure control: 52 months data of the Australian Pregnancy Registry. European Journal of Neurology, 13 6: 645-654. doi:10.1111/j.1468-1331.2006.01359.x


Author Vajda, F. J. E.
Hitchcock, A.
Graham, J.
Solinas, C.
OBrien, T. J.
Lander, C. M.
Eadie, M. J.
Title Foetal malformations and seizure control: 52 months data of the Australian Pregnancy Registry
Journal name European Journal of Neurology   Check publisher's open access policy
ISSN 1351-5101
Publication date 2006
Sub-type Article (original research)
DOI 10.1111/j.1468-1331.2006.01359.x
Volume 13
Issue 6
Start page 645
End page 654
Total pages 10
Editor M. Hillbom
Place of publication Oxford, U.K.
Publisher Blackwell Publishing
Collection year 2006
Language eng
Subject C1
320700 Neurosciences
730105 Endocrine organs and diseases (incl. diabetes)
Abstract The Australian Pregnancy Registry, affiliated European Register of Antiepileptic drugs in Pregnancy (EURAP), recruits informed consenting women with epilepsy on treatment with antiepileptic drugs (AEDs), those untreated, and women on AEDs for other indications. Enrolment is considered prospective if it has occurred before presence or absence of major foetal malformations (FMs) are known, or retrospective, if they had occurred after the birth of infant or detection of major FM. Telephone Interviews are conducted to ascertain pregnancy outcome and collect data about seizures. To date 630 women have been enrolled, with 565 known pregnancy outcomes. Valproate (VPA) above 1100 mg/day was associated with a significantly higher incidence of FMs than other AEDs (P < 0.05). This was independent of other AED use or potentially confounding factors on multivariate analysis (OR = 7.3, P < 0.0001). Lamotrigine (LTG) monotherapy (n = 65), has so far been free of malformations. Although seizure control was not a primary outcome, we noted that more patients on LTG than on VPA required dose adjustments to control seizures. Data indicate an increased risk of FM in women taking VPA in doses > 1100 mg/day compared with other AEDs. The choice of AED for pregnant women with epilepsy requires assessment of balance of risks between teratogenicity and seizure control.
Keyword Clinical Neurology
Neurosciences
Antiepileptic Drugs
Categories Of Malformations
Epilepsy
Malformations
Pregnancy
Seizure Control
Valproate Dose-related Malformations
Neural-tube Defects
Folic-acid Supplementation
Sodium Valproate
Lamotrigine
Women
Teratogenicity
Pharmacokinetics
Prevention
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2007 Higher Education Research Data Collection
School of Medicine Publications
 
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Created: Wed, 15 Aug 2007, 08:00:03 EST