Spina bifida and cleft lip among newborns of Norwegian women with epilepsy: changes related to the use of anticonvulsants.
OBJECTIVE
This study examined the connection between the use of anticonvulsants for epilepsy during or before pregnancy and the risk of spina bifida and cleft lip in newborns.


METHODS
Among mothers registered from 1967 to 1992 by the Medical Birth Registry of Norway, 7588 who had epilepsy were identified and their newborns' prevalence of spina bifida and cleft lip examined.


RESULTS
The odds ratio of spina bifida in children of mothers with epilepsy compared with other children increased from 1.5 in 1967 through 1980 (95% confidence interval [CI] = 0.3, 4.5) to 4.4 in 1981 through 1992 (95% CI = 2.0, 8.5). The odds ratio of cleft lip, however, decreased from 3.0 before 1981 (95% CI = 1.6, 5.1) to 1.1 after 1981 (95% CI = 0.4, 2.3).


CONCLUSIONS
This shift toward more serious birth defects is consistent with the different teratogenic effects of newer and older anticonvulsants.
King
P B
PB
Medical Birth Registry of Norway, University of Bergen, Norway.
Lie
R T
RT
Irgens
L M
LM
D000927:Anticonvulsants / Q000009:adverse effects*; D016022:Case-Control Studies; D002972:Cleft Palate / Q000139:chemically induced* / Q000453:epidemiology*; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008431:Maternal-Fetal Exchange; D009664:Norway / Q000453:epidemiology; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D015995:Prevalence; D012042:Registries; D016135:Spinal Dysraphism / Q000139:chemically induced* / Q000453:epidemiology*; D013723:Teratogens
D000927:Anticonvulsants; D013723:Teratogens