Epilepsy Drug in Pregnancy Linked to Spina Bifida

New research suggests women taking certain <"http://www.yourlawyer.com/topics/overview/epilepsy_drugs">epilepsy drugs —Carbatrol, Epitol, Equetrol, and Tegretol (known generically as carbamazepine)—experience a greater than two-fold risk of giving birth to babies with <"http://www.yourlawyer.com/topics/overview/spina_bifida">spina bifida, wrote WebMD.

The research team looked at nearly four million babies born in Europe between 1995 and 2005, said WebMD. Nearly 100,000 were diagnosed with major birth defects and 2,680 of the babies’ mothers took carbamazepine during their first trimester, added WebMD. According to the research, spina bifida was the only major birth defect linked to carbamazepine exposure. The study appears online in the journal BMJ Online First.

A birth defect, spina bifida is part of a group called neural tube defects. The neural tube is that part of the developing baby that ultimately forms the brain, spinal cord, and related tissues, said the Mayo Clinic. The neural tube typically closes by the 28th day after conception; however, in babies with spina bifida, a portion of the neural tube does not develop or close properly, leading to spinal cord and backbone defects, noted the Mayo Clinic.

Last June we wrote that a then-emerging study of antiepileptic drugs (AEDs) found that pregnant women taking such medications were more likely to give birth to children with certain birth defects. According to WebMD, the increase was six-fold for spina bifida in babies born to women who took the epilepsy drug Depacon, Depakene, Depakote, or Stavzor (all known generically as valproic acid).

The drugs were also linked to increased risks for cleft palate; extra digits; and hypospadia, which is a defect in the penile opening causing the opening to develop in the wrong part of the penis or scrotum, explained WebMD.

Last June’s AEDs birth defect study was presented at the 62nd Annual Meeting of the American Epilepsy Society, and found that valproate was strongly associated with an increased risk of birth defects and that other AEDs such as lamotrigine and carbamazepine also suggested increased risks.

That study also found that 16 major malformations occurred in the offspring of 149 women who used valproate during pregnancy, and these malformations included neural tube defects, craniofacial defects, cardiovascular malformations, and malformations involving other body systems.

The recent study strengthens American Academy of Neurology guidelines recommending avoiding valproic acid, when possible, during pregnancy, wrote WebMD. Some warn that this is not always possible, and switching anti-seizure medications during or just prior to pregnancy is not recommended.

“If carbamazepine is effective for controlling seizures, it is clearly the best choice,” said study researcher Lolkje de Jong-van den Berg, a professor in pharmacoepidemiology at the University of Groningen in the Netherlands, who also told WebMD. “But this is not always the case. In some cases, valproic acid may be the only effective option.”

The new study found that babies exposed to carbamazepine or valproic acid before birth experienced a 2.6-fold and 7.7-fold increased risk—respectively—for spina bifida, versus babies with no exposure, said WebMD.

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