title: Prediction of the hazard of foetal malformation in pregnant women with epilepsy.
abstract: The data collected in the Australian Register of antiepileptic drugs in pregnancy have been studied in the hope of defining simple items of information that could be recorded at initial interview of pregnant women with epilepsy, and which might allow estimation of the risk of the pregnancy resulting in a malformed foetus. Analysis of the data showed that dose of valproate, but not intake of other commonly used antiepileptic drugs, in the current pregnancy, and a past history of a pregnancy involving a malformed foetus, statistically significantly increased the malformation hazard in the current pregnancy, and that continuing alcohol intake might decrease it. Plotting the hazard against valproate dose in monotherapy, with or without histories of (i) previous pregnancies with foetal malformations (FMs), and (ii) continuing alcohol intake, provided quantitative information concerning the degree of increased risk. It is hoped that this information may help in advising about the risk of foetal malformation (FM) in individual pregnancies.
authors.affiliation: Department of Medicine and Neurosciences, Royal Melbourne Hospital and University of Melbourne, Parkville, Victoria 3050, Australia. Electronic address: vajda@netspace.net.au.
authors.forename: F J E
authors.initials: FJ
authors.lastname: Vajda
authors.affiliation: Department of Medicine and Neurosciences, Royal Melbourne Hospital and University of Melbourne, Parkville, Victoria 3050, Australia.
authors.forename: T J
authors.initials: TJ
authors.lastname: O'Brien
authors.affiliation: Department of Medicine and Neurosciences, Royal Melbourne Hospital and University of Melbourne, Parkville, Victoria 3050, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Graham
authors.affiliation: Royal Brisbane and Women's Hospital and University of Queensland, Brisbane, Queensland 4027, Australia.
authors.forename: C M
authors.initials: CM
authors.lastname: Lander
authors.affiliation: Royal Brisbane and Women's Hospital and University of Queensland, Brisbane, Queensland 4027, Australia.
authors.forename: M J
authors.initials: MJ
authors.lastname: Eadie
mesh_terms: D000014:Abnormalities, Drug-Induced / Q000453:epidemiology; D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D001315:Australia / Q000453:epidemiology; D004827:Epilepsy / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D011247:Pregnancy; D049188:Prenatal Injuries / Q000453:epidemiology; D016016:Proportional Hazards Models; D012042:Registries; D012306:Risk; D014635:Valproic Acid / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D014635:Valproic Acid
keywords: Alcohol; Antiepileptic drugs; Foetal malformations; Spina bifida; Teratogenesis; Valproate