Despite methodological distinctions, results suggest that low-dose monotherapy is an ideal goal during pregnancy.
Major congenital malformations (MCMs) are of concern to clinicians who prescribe antiepileptic drugs to women of reproductive age. Three recent studies of antiepileptic drug therapy during pregnancy have yielded varying results about the risks and benefits of these agents.
In the manufacturer-sponsored International Lamotrigine Pregnancy Registry study (recruitment, 1992–2009), women (65% from the U.S.) voluntarily enrolled — preferably early during pregnancy — through their clinicians, who provided information about pregnancy outcomes. Earliest exposure occurred during the first trimester in most pregnancies. MCMs were reported in 2.2% of infants born to women who received lamotrigine monotherapy, 10.7% of offspring of women who received la…