TY - JOUR
T1 - Course of pregnancy and fetal outcome following maternal exposure to carbamazepine and phenytoin
T2 - A prospective study
AU - Gladstone, David J.
AU - Bologa, Monica
AU - Maguire, Cara
AU - Pastuszak, Anne
AU - Koren, Gideon
N1 - Funding Information:
Acknowledgment -- Mr. Gladstone was supported by a summer studentship grant from the Institute of Medical Sciences, University of Toronto.
PY - 1992
Y1 - 1992
N2 - This prospective study followed the pregnancy course of epileptic women at the Motherisk Program of The Hospital for Sick Children, Toronto. We compared fetal outcome of women treated with carbamazepine (CBZ), those treated with diphenylhydantoin (phenytoin, DPH), and a drug-free control group. Seizures were reported in 15 pregnancies; in a subgroup of 9 women without change in drug or schedule, an increase in seizure frequency was evident in 6, a decrease in 1, and no change in 2, regardless of the drug taken. Of 23 children exposed to CBZ in utero, one was born with a lumbar myelomeningocele and multiple congenital anomalies. Of 21 children exposed to DPH, there was one case of severe developmental delay and four with minor features of fetal hydantoin syndromes (FHS). The three groups did not differ in birth weights or gestational ages of the babies. Although much more experience is needed, as a result of this study and other similar reports, Motherisk now offers women treated with CBZ diagnostic tests to detect neural tube defects during the second trimester of pregnancy.
AB - This prospective study followed the pregnancy course of epileptic women at the Motherisk Program of The Hospital for Sick Children, Toronto. We compared fetal outcome of women treated with carbamazepine (CBZ), those treated with diphenylhydantoin (phenytoin, DPH), and a drug-free control group. Seizures were reported in 15 pregnancies; in a subgroup of 9 women without change in drug or schedule, an increase in seizure frequency was evident in 6, a decrease in 1, and no change in 2, regardless of the drug taken. Of 23 children exposed to CBZ in utero, one was born with a lumbar myelomeningocele and multiple congenital anomalies. Of 21 children exposed to DPH, there was one case of severe developmental delay and four with minor features of fetal hydantoin syndromes (FHS). The three groups did not differ in birth weights or gestational ages of the babies. Although much more experience is needed, as a result of this study and other similar reports, Motherisk now offers women treated with CBZ diagnostic tests to detect neural tube defects during the second trimester of pregnancy.
KW - antiepileptic drugs
KW - birth defects
KW - carbamazepine
KW - diphenylhydantoin
KW - fetal hydantoin syndrome
KW - phenytoin
UR - http://www.scopus.com/inward/record.url?scp=0026482314&partnerID=8YFLogxK
U2 - 10.1016/0890-6238(92)90181-R
DO - 10.1016/0890-6238(92)90181-R
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C2 - 1591483
AN - SCOPUS:0026482314
SN - 0890-6238
VL - 6
SP - 257
EP - 261
JO - Reproductive Toxicology
JF - Reproductive Toxicology
IS - 3
ER -