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Monday, 11 June, 2001, 23:22 GMT 00:22 UK
Pregnancy warning over epilepsy drugs
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Epilepsy drugs can pose a risk to unborn babies
Babies are being born with serious malformations because women are not being told about the potential dangers of drugs to control epilepsy.

Epilepsy drugs taken in normal doses can increase the risk that an unborn child will be born with serious malformations such as spina bifida.


There is an appalling lack of knowledge in general practice

Dr Tim Betts
For this reason it is important that women with epilepsy seek medical advice before they become pregnant, so that if necessary their doses are reduced to safer levels.

But a report by the magazine Health Which? suggests that women are not being given this vital information.

It highlights a study which compared pregnant women with epilepsy who had received counselling about the risk before they became pregnant, with those who had not.

Big difference

None of the 90 women who received counselling gave birth to babies with malformations.

But 11 of the 59 women who did not receive counselling did have malformed children.

Dr Tim Betts, a consultant neuropsychiatrist at the Birmingham clinic which carried out the study, told Health Which? the risks of malformation were greatly reduced if anti-epileptic drugs were given in safe quantities following advice from specialists.

But he said GPs can often give poor advice because of a lack of knowledge in the field.

He said: "There is an appalling lack of knowledge in general practice."

Dr Margaret Jackson, a consultant neurologist at the Royal Victoria Infirmary in Newcastle, agreed: "It would be of great concern if these drugs were used in women of reproductive age and they weren't made aware of this."

The magazine quotes a survey by the government's Clinical Standards Advisory Group which published results from a survey of 642 women about information they had been given on the need for pre-pregnancy planning.

Only 35% said they had received any information and fewer than half had been told of potential risks posed by anti-epileptics, said Health Which?.

Malformations

Child malformations associated with epileptic mothers include spina bifida, malformations of the heart and sexual organs and cleft palate.

Other less severe malformations include wide set eyes or thin lips.

Women suffering from epilepsy are thought to have an increased chance of giving birth to a baby with malformations, the report said.

But if women take anti-epilepsy drugs that chance is widely thought to be increased. Between 6% and 10% of babies born to women taking anti-epileptics suffer malformations.

The chance of malformation is increased if the woman takes more than one type of anti-epileptic.

The Medicines Control Agency has received hundreds of reports about malformations with a suspected link to anti-epileptic drugs.

Nearly 400 have been associated with valproate, and more than 100 each with phenytoin and carbamazepine.

Health Which? also reports that anti-epileptics may also affect a child's mental development.

The British Epilepsy Association issued a statement saying: "BEA acknowledge that some anti epileptic drugs can increase the risk of the baby having medical problems, this is why BEA always advise women with epilepsy to consider pre-conception counselling when thinking of starting a family.

"Pre-conception counselling would ideally involve a team of three doctors - a GP, an epilepsy specialist and an obstetrician.

"These doctors should communicate with each other as early as possible to discuss medication and any changes that may be needed during pregnancy."

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See also:

22 Mar 01 | Health
Call for epilepsy action
19 Feb 01 | Health
Epilepsy advance brings cure hope
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