Pregnancy risks linked to antiepileptic drugs

June 24, 2011

Women with epilepsy are more likely to have complications during pregnancy, and the complications are ?largely associated with the use of antiepileptic drugs,? a recent Norwegian study reveals.

Women with epilepsy are more likely to have complications during pregnancy, and the complications are “largely associated with the use of antiepileptic drugs,” a recent Norwegian study reveals.

Researchers compared medical records of the pregnancies of 205 women with epilepsy and an equal number of women without epilepsy who delivered in Bergen between 1999 and 2006. Their study, published online in BJOG: An International Journal of Obstetrics and Gynaecology (2011;118[8]:956-965), also compared epileptic women who were taking antiepileptic drugs (AEDs) with epileptic women who weren’t.

Epileptic women were more than twice as likely as women without epilepsy to develop preeclampsia and 4 times more likely to have severe preeclampsia. They were also 3.8 times more likely than nonepileptic women to have vaginal bleeding early in pregnancy, 1.8 times more likely to require cesarean delivery or induced labor, almost 6 times more likely to give birth prematurely, and 6.5 times more likely to have an infant with malformations. Generalized epilepsy was associated with most pregnancy and delivery complications.

An analysis of pregnancy and delivery risks among the women with epilepsy revealed that nearly 8% of women who took AEDs developed severe preeclampsia compared with fewer than 3% who didn’t take drugs; women taking AEDs were more than twice as likely as unmedicated women to undergo induced labor or emergency cesarean delivery.

“These risks were associated with the use of AEDs in pregnancy. We were unable to demonstrate any other factors influencing these risks,” the researchers observe. “The epilepsy itself had less influence, as women with active epilepsy without AED use had no excessive risks.” Women who didn’t take AEDs had risks for some complications, such as bleeding and induced cesarean delivery, similar to those of nonepileptic women whereas women taking AEDs were at increased risk for all complications.

The study results don’t imply that epileptic women should discontinue AEDs during pregnancy inasmuch as the potential risks of the drugs don’t outweigh the known risks of seizures, emphasizes lead author Ingrid Borthen, MD. She notes that the overall risk of medication-related complications is low.