engleski

Effect of maternal antiepileptic therapy on fetal growth

As many pregnant women take antiepileptic drugs, it quite understandably raises concern about their possible adverse effects on fetal growth. Studies indicate that these pregnancies are at high risk of stillbirth, intrauterine growth retardation, and decreased cranial circumference. The risk of congenital anomalies is 2-to 7-fold that in the general population, with the prevalence of anomalies of 9-10%. This risk depends on the type and dose of drug, maternal blood drug concentation, use of montherapy/polytherapy, and less frequently on the maternal disease itself. Morphological and functional lesions in children include dysmorphism that can be consistent with some syndrome patterns (fetal hydantoin, phenytoin, or valproate syndromes), and malformations (anomalies of the central nervous system, cardiac defects,cleft palate) characteristic of a particular drug or drug combination. Severe malformations are found in some 5% of children. Recently, studies of longterm effects of antiepileptic therapy on the childrens intellectual development are in the focus of interest, because retardation in the form of specific deficits (retarded development of speech, motor disturbances) and behavioral disturbances have been recorded. Recent studies of the pathogenetic mechanisms of the effect of antiepiletpic therapy on fetal growth and development are discussed, and preventive measures in the form of algorithm for the follow -up of pregnant women and children intrauterinely exposed to the action of antiepileptics are proposed.

antiepiletpic drugs; pregnancy

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