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Newer Epilepsy Meds Less Likely to Cause Birth Defects: Study
Date:5/17/2011

y during pregnancy is that treatment needs to be individualized, and not all women respond to all treatments. In many cases, it takes more than one medication to control seizures. And, uncontrolled epilepsy can also cause harm to a fetus, according to Dr. Loralei Thornburg, a maternal-fetal medicine specialist at the University of Rochester's Strong Memorial Hospital in New York, who was not involved with the study.

Medication options for women with epilepsy increased in the 1990s, but because these drugs are relatively new, little information has been available about their potential risk in pregnant women, the authors of the new study pointed out.

For the current study, Molgaard-Nielsen and a colleague reviewed data on all live births in Denmark from January 1996 through September 2008. The study included a total of 837,795 live births, including 1,532 babies who were exposed to newer epilepsy medications during the first trimester of pregnancy.

In the group of babies exposed to newer medications, such as lamotrigine, oxcarbazepine, topiramate, gabapentin and levetiracetam, 49 (3.2 percent) were diagnosed with major birth defects. In the large group of babies who weren't exposed to epilepsy medications, 19,911 babies (2.4 percent) were diagnosed with a major birth defect, according to the report.

Although the overall rates of birth defects were low, the study authors found that babies exposed to topiramate had 44 percent higher odds of having a birth defect, while babies exposed to lamotrigine during the first trimester of pregnancy had 18 percent higher odds of a birth defect. Those exposed to oxcarbazepine had 14 percent lower odds of a birth defect, the results showed.

There weren't enough women taking gabapentin or levetiracetam to estimate whether or not these medications are associated with increased odds of birth defects, the study authors noted.

"The management of epilepsy is complicated and challenging, and should be
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