Taking Specific Antiseizure Drugs During Pregnancy Linked To Increased Risk Of Malformations At Birth

A caller study that examined older and newer medications to dainty seizures has recovered that utilizing immoderate medications during gestation is linked to an accrued consequence of malformations astatine birth, aliases commencement defects. The study is published July 16, 2025, successful Neurology®, nan aesculapian diary of nan American Academy of Neurology.

Seizures tin lead to falls and different complications during pregnancy, truthful seizure power for those pinch epilepsy is important to protect nan wellness of some nan mother and child. While immoderate older narcotics are known to summation nan consequence of awesome malformations, little is known astir nan information of newer 'second generation' medications. Our study looked astatine a number of narcotics and provides valuable accusation for wellness attraction providers and group who whitethorn go pregnant to make much informed decisions astir nan usage of these medications during pregnancy."

Sonia Hernandez-Diaz, MD, DrPH, study author, Harvard T.H. Chan School of Public Health successful Boston, Massachusetts

For nan study, researchers looked astatine 7,311 women who were taking an antiseizure medicine during nan first trimester of pregnancy. They were compared to 1,311 women who did not return antiseizure medications.

Participants completed telephone interviews astatine nan commencement of nan study, astatine 7 months pregnant, and wrong 3 months aft delivery.

Researchers confirmed commencement defects done aesculapian records. These included cleft lip, larger-than-normal holes successful nan heart, neural conduit defects wherever nan spinal cord does not create decently specified arsenic spina bifida, missing aliases underdeveloped limbs and different issues wherever parts of nan assemblage did not shape correctly.

They past looked astatine nan consequence of these commencement defects among infants exposed to circumstantial antiseizure medications taken during nan first trimester of gestation and compared them to infants exposed to lamotrigine, an antiseizure medicine utilized arsenic nan reference group.

Researchers recovered that nan consequence of awesome commencement defects varied among medications. Valproate posed nan highest risk, pinch awesome commencement defects occurring successful 9% of infants exposed. Phenobarbital followed astatine 6%. Among newer drugs, commencement defects occurred successful 5% of those exposed to topiramate, while nan group exposed to lamotrigine had malformations successful 2% of births.

When compared to those who took lamotrigine, those who took valproate had much than 5 times nan consequence of commencement defects, those who took phenobarbital had astir 3 times nan risk, and those taking topiramate had complete doubly nan risk.

"Our results corroborate that utilizing valproate, phenobarbital aliases topiramate during early gestation is linked to a higher chance of awesome commencement defects successful nan infants erstwhile compared to lamotrigine," Hernandez-Diaz said. "On nan different hand, our results did not show an accrued consequence pinch medications for illustration levetiracetam, oxcarbazepine, gabapentin and zonisamide. For lacosamide and pregabalin, nan information wasn't clear capable to make coagulated conclusions, truthful much investigation is needed."

A limitation of nan study was that participants were enrolled months aft conception and successful astir cases early losses of gestation were not assessed for malformations, truthful nan number of malformations wide whitethorn person been underestimated.