Congenital Anomalies in the Offspring of Epileptic Mothers*

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  • Congenital anomalies in the offspring o

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ABSTRACT The incidences of various complications during pregnancy are not significantly different between epileptic and nonepileptic mothers in the majority of papers so far reported. More than 70 to 80% of women with epilepsy will have no change in seizure frequency, while 5% will have fewer seizures than before and the remaining patients will have more seizures during pregnancy provided that their drug compliance is good. Intrauterine growth, in particular, of head circumference of fetus is delayed. However, this retardation disappears within few years after birth. The risk of congenital malformations of the offspring born to treated epileptic mothers is greater than in the general population. Among risk factors for teratogenesis that had been considered to date, only antiepileptic drug (AED)-related factors had proved to be significantly related to the occurrence of malformations. Among AEDs, methylphenobarbital, valproate, primidone, carbamazepine and phenytoin are teratogenic, particularly when they are used in combination. Follow up EEG of children born to epileptic mothers revealed that the incidence of abnormal EEG was 44%, and 28 to 38% showed epileptiform patterns. Only 7% of offspring had epileptic seizures. In the offspring without clinical seizures revealed that most of the epileptiform patterns disappear after the age 10. Recommendations concerning AED therapy during pregnancy are also discussed.

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