Sodium valproate leads to birth defects

Roughly 20 percent of epileptic women who take the anti-seizure drug sodium valproate during pregnancy tend to have a fetus with a serious adverse outcome; almost twice the rate associated with the next most problematic ant epileptic drug. Previous studies have issued guidelines for treating epileptic women during pregnancy. Since anti-epileptic drugs, in general, have been linked to adverse fetal outcomes, the strategy was to optimise treatment before conception, using a single anti-epileptic drug if possible, at the lowest effective dose. These guidelines did not, however, differentiate between the various drugs for their potential to cause birth defects. The initial focus of the current study wasn't to look at the rate of birth defects and fetal deaths associated with anti-epileptic drugs. The researchers wanted to look at the impact of these drugs on neurodevelopmental later in life. They were only monitoring the children until they became old enough to complete the tests. Then the early effects came to light. Researchers from the University of Florida in Gainesville, USA, studied 333 pregnant women who were drawn from 25 epilepsy centers. All of the women were receiving anti-epileptic therapy with a single drug, including carbamazepine in 110, lamotrigine in 98, phenytoin in 56 and valproate in 69. The rate of serious adverse outcomes, which included congenital malformation and fetal death, was 20.3 percent for valproate, 10.7 percent for phenytoin, 8.2 percent for carbamazepine, and 1.0 percent for lamotrigine. Sodium valproate use was associated with two fetal deaths and 12 congenital malformations, including skull deformities, heart structural abnormalities, kidney swelling due to backup of urine; and cleft palate, a birth defect in which the mouth or lip tissues don't properly form during development; and several others. However, for women who fail to response to other anti-epileptic drugs and must use valproate, the doctor should emphasise that despite the increased risk of adverse outcomes, the majority of pregnant women who take the drug have normal, healthy babies.