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Title: Fetal malformations in successive pregnancies in Australian women with epilepsy.
Austin Authors: Vajda, Frank;O'Brien, Terence;Graham, Janet;Hitchcock, Alison;Perucca, Piero ;Lander, Cecilie;Eadie, Mervyn
Affiliation: Departments of Medicine and Neurosciences, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria 3050, Australia..
Department of Neurology, Alfred Health, Melbourne, VIC 3004, Australia..
Department of Neuroscience, Monash University, Melbourne, VIC 3004, Australia..
Medicine (University of Melbourne)
Comprehensive Epilepsy Program
Royal Brisbane and Women's Hospital and School of Medicine and Biomedical Science, University of Queensland, Brisbane, QLD 4027, Australia..
Issue Date: 18-Jul-2022
Date: 2022
Publication information: Epilepsy & Behavior: E&B 2022-09; 134: 108848
Abstract: To utilize data from the Australian Register of Antiepileptic Drugs in Pregnancy (APR) to determine the hazard of fetal malformation in the subsequent pregnancy or pregnancies in women with epilepsy following a pregnancy associated with a fetal malformation, and to identify factors relevant to the hazard. There was a 7.4% initial pregnancy fetal malformation rate. The subsequent pregnancy malformation rate was 4.2% if there was no initial pregnancy malformation, but 21.2% if there was an initial pregnancy malformation (O.R. = 6.1448, 95% C.I. 2.3396, 16.1386). For pregnancies where antiseizure medication (ASM) therapy was unchanged between pregnancies (N = 196), the initial pregnancy malformation rate was 10.2%, but 30.0% in the subsequent pregnancy if there was a malformation in the initial pregnancy, and 2.35% if there was none (O.R. = 17.7857, 95% C.I. 4.4847, 70.5361). A cohort comprising 24% of the women with fetal malformations in their initial pregnancies seemed to be intrinsically vulnerable to fetal malformation during successive pregnancies: when their seizure disorder type had been recorded all had genetic generalized epilepsies, compared with a 45.8% generalized epilepsy rate in women with initial but not subsequent pregnancy malformations (P = 0.0121). If fetal malformation had occurred in an initial ASM-treated pregnancy there was a significantly increased hazard of fetal malformation in the subsequent pregnancy, particularly if the woman involved had a genetic generalized epilepsy.
DOI: 10.1016/j.yebeh.2022.108848
ORCID: 0000-0002-7855-7066
Journal: Epilepsy & behavior : E&B
PubMed URL: 35863138
PubMed URL:
Type: Journal Article
Subjects: Antiseizure medication
Fetal malformation
Successive pregnancies
Appears in Collections:Journal articles

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