title: Spontaneous abortion and the prophylactic effect of folic acid supplementation in epileptic women undergoing antiepileptic therapy.
abstract: BACKGROUND
  Antiepileptic drugs (AEDs) like phenytoin (PHE), carbamazepine (CBZ), barbiturates and valproic acid (VPA) interfere with folic acid absorption and metabolism, which in turn can be the cause of adverse pregnancy outcome.
  
  
  OBJECTIVE
  To study the prophylactic effect of folic acid supplementation with regard to spontaneous abortion and preterm delivery (fetal demise after week 20 of gestational age) in pregnant women receiving AED therapy, as well as benefits of most common dosage and preconceptional commencement.
  
  
  METHODS
  Prospective examination of 104 patients, registered in EURAP from 1999-2004 at a single center and a retrospective analysis of data from our epilepsy databank completed with medical records and patients interviews of the Department of Neurology of Innsbruck University Hospital from 1971 to 1999.
  
  
  RESULTS
  388 pregnancies in 244 patients were analyzed. Pregnancies with folic acid supplementation showed significant reduction of spontaneous abortion. With regard to monotherapies, in the group of women taking VPA, supplementation of folic acid had significant benefit. Other examined monotherapies (CBZ, PHE, and PB) known to interfere with folic acid showed no significant results.
  
  
  CONCLUSIONS
  This study confirms the prophylactic effect of folic acid supplementation on spontaneous abortion. For AED therapy, folic acid supplementation should be part of the therapy of every pregnant epileptic woman, especially for those treated with VPA.
authors.affiliation: Department of Neurology, Medical University Innsbruck, Anichstrasse 35, Innsbruck, Austria.
authors.forename: Sabine
authors.initials: S
authors.lastname: Pittschieler
authors.forename: Christoph
authors.initials: C
authors.lastname: Brezinka
authors.forename: Beate
authors.initials: B
authors.lastname: Jahn
authors.forename: Eugen
authors.initials: E
authors.lastname: Trinka
authors.forename: Iris
authors.initials: I
authors.lastname: Unterberger
authors.forename: Judith
authors.initials: J
authors.lastname: Dobesberger
authors.forename: Gerald
authors.initials: G
authors.lastname: Walser
authors.forename: Andrea
authors.initials: A
authors.lastname: Auckenthaler
authors.forename: Norbert
authors.initials: N
authors.lastname: Embacher
authors.forename: Gerhard
authors.initials: G
authors.lastname: Bauer
authors.forename: Gerhard
authors.initials: G
authors.lastname: Luef
mesh_terms: D000022:Abortion, Spontaneous / Q000139:chemically induced* / Q000188:drug therapy / Q000517:prevention & control*; D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects*; D019587:Dietary Supplements; D004827:Epilepsy / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage*; D006801:Humans; D011247:Pregnancy; D047928:Premature Birth / Q000139:chemically induced / Q000188:drug therapy / Q000517:prevention & control; D011446:Prospective Studies; D012189:Retrospective Studies
chemical_list: D000927:Anticonvulsants; D005492:Folic Acid