Magazine article Clinical Psychiatry News

Impact of Prenatal Exposure to Anticonvulsants Appears Small

Magazine article Clinical Psychiatry News

Impact of Prenatal Exposure to Anticonvulsants Appears Small

Article excerpt

TUCSON, ARIZ. -- The use of carbamazepine, phenytoin, or phenobarbital as monotherapy by pregnant women was not associated with significant deficits in full-scale IQ in their offspring, a small study showed.

However, these data counter previous reports of lowered intellectual ability in children born to mothers who took anticonvulsant medications during pregnancy, Dr. Kenneth Lyons Jones said at the annual meeting of the Teratology Society.

"The results, then, should be considered in conjunction with previous studies when evaluating the risks associated with use of these medications during pregnancy," cautioned Dr. Jones, chief of the division of dysmorphology and teratology in the department of pediatrics at the University of California, San Diego.

Despite the documented increased risk for certain major malformations following prenatal exposure to anticonvulsants, he said that "substantial controversy" exists about their impact on neurobehavioral outcomes.

"Compounding these concerns is the fact that in the United States, between 7.6 and 12.7 million women have epilepsy, and 95% of them are being treated with anticonvulsant drugs," Dr. Jones said. "In addition, 1 in every 200 pregnant women in the general population requires antiepileptic medication during their pregnancy."

Dr. Jones and his associates studied 82 children aged 4-14 years whose mothers were taking anticonvulsant monotherapy and contacted the California Teratogen Information Service (CTIS) during their pregnancies. Of the 82 children, 30 were exposed to carbamazepine, 23 were exposed to phenytoin, and 29 were exposed to phenobarbital.

The researchers randomly selected 50 matched controls who were born to women who contacted CTIS because of an exposure not deemed to be teratogenic.

All children underwent neuropsychiatric testing that included a measure of full-scale IQ (FSIQ). …

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