For women taking multiple anticonvulsants, pregnancy carries increased birth defects risk
In the study “Fetal Effects of Anticonvulsant Polytherapies” published in yesterday's Journal of the American Medical Association online, researchers found that pregnant women taking anticonvulsant polytherapy (more than one anticonvulsant medication at a time) had higher risks of giving birth to a child with congenital defects than women only taking one anticonvulsant—but only when polytherapy included valproate sodium, also known as Depakote.
The authors of the study suggest that “counseling for fetal risks from AED [antiepileptic drug] polytherapy should be based on the specific drugs included.” Their study focused on the birth defect risks associated with polytherapy using carbamazepine(also known as Carbatrol and Tegretol) and lamotrigine (brand name Lamictal), and the interaction of those two specific drugs with other anticonvulsants. Pregnancy birth defect risks increased when either one of the two AEDs interacted with valproic acid.
Consider that the risk of malformations is 1.9% among infants who were exposed to Lamictal monotherapy while in utero, and 2.9% for infants exposed to Carbatrol monotherapy. An infant exposed to Lamictal in combination with Depakote encountered a 9.1% risk of malformations, and an infant exposed to Carbatrol (or Tegretol) in combination with Depakote faced a 15.4% risk of malformations.
It was the combination of certain anticonvulsants during pregnancy that affected the children's risk of birth defects the most. For example, an infant exposed to Lamictal alone faced a 1.9% risk of malformations, and a 2.9% risk of malformations if exposed to Lamictal and any other anticonvulsant. But when exposed to Lamictal and Depakote, the infant had a 9.1% risk, as stated above.
The researchers, made up of doctors from the Harvard School of Public Health, MassGeneral Hospital for Children, and the Pediatric, Obstetric, and Gynecology Departments of Loyola University Health System, found that taking considerations such as the mother's vitamin intake prior to pregnancy, smoking and drinking habits, and chronic diseases did not explain their results.
If your child experienced health problems due to exposure to anticonvulsants during your pregnancy, you have legal options. For more information about your legal rights, contact Weitz & Luxenberg at 1-800-476-6070, or fill out a form to receive a free legal consultation.
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