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Wednesday, 10 April, 2002, 23:07 GMT 00:07 UK
Babies of epileptic women at risk
Epilepsy is the tendency to have recurrent seizures
Epilepsy is the tendency to have recurrent seizures
Babies born to women taking epilepsy medication through pregnancy are at treble the risk of learning disorders and birth defects, a study has shown.

The drugs increase the risk of congenital defects, such as hernias, hip dislocation, heart disease, cleft palate and abnormal genital development.

But a study in the Journal of Medical Genetics also links the drugs to speech problems, sitting or walking late, and learning difficulties.

Women who are taking epilepsy medication are strongly urged by experts not to stop if they are pregnant, or planning to have children.


It is essential that women seek pre-conception counselling before considering pregnancy

Phil Lee, British Epilepsy Association
Stopping treatment could lead cause harm to them and their baby.

The second most common cause of maternal death in the UK is due to epilepsy in women who are no longer taking their medication.

Instead, women are advised to see their doctor and have their epilepsy treatment reviewed.

In the long term, the researchers say there is an urgent need to develop safer drugs.

Epilepsy is the tendency to have recurrent seizures. Around three-quarters of people with epilepsy in the UK have their seizures well controlled by medication.

Six in every 1,000 pregnancies will be to a woman treated with epilepsy drugs.

Exposure

The research team looked at 149 mothers being treated with anti-epileptic drugs in the Grampian region of Scotland who attended the Aberdeen Maternity Hospital.

They gave birth to 293 children between 1976 and 2000.

Thirty-eight had not been exposed to epilepsy treatment while in the womb, either because the mothers did not take the drugs, or because epilepsy had not been diagnosed at the time.

The researchers examined the children exposed to drugs.

They found almost one in five had developmental or speech delays - more than five times the rate among children not exposed during the pregnancy.

Around a third had medical problems in early childhood. One in four had behavioural disorders, including autism, compared with 5% of those not exposed to these drugs.

One in five also had symptoms of drug withdrawal after birth, including feeding problems, seizures, and low blood glucose levels.

Around half had some facial characteristics associated with exposure to epilepsy drugs, a rate that was double that of children who had not been exposed to these drugs.

A third had either abnormalities that required surgery or learning disorders.

Even where there was no family history of learning disorders, 28% of children whose mothers had been treated with epilepsy drugs had developmental problems.

In the general population up to 7% of 3 to five-year olds would normally be affected.

The drug carbamazepine was associated with an increased risk, as was taking more than one anti-convulsant drug during pregnancy.

Counselling 'crucial'

The authors wrote in the Journal of Medical Genetics: "This study highlights the high frequency of later childhood complications associated with maternal epilepsy and its treatment, and emphasises the need for appropriate counselling and support of epileptic mothers."

They add: "The importance of further research into susceptibility factors, the development of safer drugs, and the appropriate counselling and management of epileptic women cannot be overemphasised."

Phil Lee, chief executive of British Epilepsy Association, said: "It is essential that women seek pre-conception counselling before considering pregnancy.

"This is so they can be stabilised on an appropriate anti-epileptic drug to control seizures whilst proposing the least minimum risk to the unborn child.

"GPs should regularly see women with epilepsy in order to hear their concerns, not rely on giving them repeat prescriptions without seeing them for long periods."

A recent BEA study found around a fifth of women with epilepsy who already had children were not given any information about pregnancy and epilepsy medication.

Women who would like a copy of the BEA's leaflet 'Women and Epilepsy' or confidential advice and information can phone a freephone helpline on 0808 800 5050.

See also:

02 Apr 02 | Health
Epileptic women pregnancy danger
20 Dec 00 | Health
Epilepsy drugs pregnancy warning
15 Sep 00 | Health
Doctors 'failing epileptic women'
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