Fetal Safety of Newer Antiepileptic Drugs During Pregnancy

Risk for major congenital malformations is low for most AEDs, although newer AEDs are not necessarily safer than older ones.

Increasing numbers of reproductive-aged women with epilepsy are being prescribed newer antiepileptic drugs (AEDs; lamotrigine, levetiracetam, and topiramate) over traditional AEDs (e.g., carbamazepine, phenytoin, valproate); however, fetal safety remains a concern. Researchers assessed rates of major congenital malformations (MCMs) diagnosed within 12 weeks after birth in offspring of North American AED Pregnancy Registry participants (enrolled from 1997 to 2011) who received monotherapy with old or new AEDs during the first trimester. An internal comparison group recruited through the registry consisted of pregnant women without epilepsy who were not taking AEDs.

In all, 4899 women receiving AED monotherapy (92% for epilepsy) and 442 unexpo…

Reviewing Author

Autumn Klein, MD, PhD

Fetal Safety of Newer Antiepileptic Drugs During Pregnancy

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Reviewing Author