Pregnancy, delivery, and neonatal complications after treatment with antiepileptic drugs

Abstract

Aim: To study the risk for complications during pregnancy, delivery, and neonatal period after the use of antiepileptic drugs (AEDs) during pregnancy.

Methods: Women treated with AEDs during pregnancy and with singleton deliveries were identified from the Swedish Medical Birth Registry during the period July 1 1995 to and including 2001 (n = 1350). Risk estimates were made using the Mantel-Haenszel procedure and comparisons with all singleton births in Sweden during this period (n = 559,491). Stratification was made for year of birth, maternal age, parity, and smoking habits.

Results: Most of the women (n = 1207, 89%) used AEDs in monotherapy. Carbamazepine was the most commonly used drug (n = 683), followed by valproic acid (n = 255). The rate of caesarean sections was significantly increased (OR = 1.64, 95% CI 1.43-1.89), but it was not possible to differentiate between elective and emergency sections. The risk for pre-eclampsia (OR = 1.66, 95% CI 1.32-2.08) and for hemorrhage after vaginal delivery was increased (OR = 1.29, 95% CI 1.02-1.63). The neonates showed an increased risk for respiratory distress (OR = 2.06, 95% CI 1.62-2.63).

Conclusion: The study demonstrates a slightly increased risk only for preeclampsia, vaginal hemorrhage after delivery, and respiratory distress in the newborn after the use of AEDs during pregnancy.