Congenital Anomalies in the Offspring of Epileptic Mothers

概要

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The incidences of various complications during pregnancy are not significantlydifferent between epileptic and nonepileptic mothers in the majority of papersso far reported. More than 70 to 80010 of women with epilepsy will have no change inseizure frequency, while 5010 will have fewer seizures than before and the remaining patientswill have more seizures during pregnancy provided that their drug compliance isgood. Intrauterine growth, in particular, of head circumference of fetus is delayed.However, this retardation disappears within few years after birth. The risk of congenitalmalformations of the offspring born to treated epileptic mothers is greater than inthe general population. Among risk factors for teratogenesis that had been consideredto date, only antiepileptic drug (AED)-related factors had proved to be significantly relatedto the occurrence of malformations. Among AEDs, methylphenobarbital, valproate,primidone, carbamazepine and phenytoin are teratogenic, particularly when they areused in combination. Follow up EEG of children born to epileptic mothers revealed thatthe incidence of abnormal EEG was 44010, and 28 to 38010 showed epileptiform patterns.Only 7010 of offspring had epileptic seizures. In the offspring without clinical seizuresrevealed that most of the epileptiform patterns disappear after the age 10. Recommendationsconcerning AED therapy during pregnancy are also discussed.
日本先天異常学会の論文
1992-12-30