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JAMA Clinical Evidence Synopsis
November 7, 2017

Maternal Use of Antiepileptic Agents During Pregnancy and Major Congenital Malformations in Children

Author Affiliations
  • 1Division of Evolution and Genomic Science, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, England
  • 2Royal Manchester Children’s Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester, England
  • 3Department of Psychology, Faculty of Arts and Sciences, Edge Hill University, Ormskirk, England
  • 4Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, England
  • 5Walton Centre NHS Foundation Trust, Liverpool, England
JAMA. 2017;318(17):1700-1701. doi:10.1001/jama.2017.14485

Clinical Question  Is maternal use of antiepileptic drugs during pregnancy associated with major congenital malformations in children?

Bottom Line  Certain antiepileptic drugs were associated with increased rates of congenital malformations (eg, spina bifida, cardiac anomalies). Lamotrigine (2.31% in 4195 pregnancies) and levetiracetam (1.77% in 817 pregnancies) were associated with the lowest risk and valproate was associated with the highest risk (10.93% in 2565 pregnancies) compared with the offspring of women without epilepsy (2.51% in 2154 pregnancies).

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