Antiepileptic Drug Use in Pregnancy Likely Not Associated with Spontaneous Abortion — Physician’s First Watch
Antiepileptic Drug Use in Pregnancy Likely Not Associated with Spontaneous Abortion
By Amy Orciari Herman
Use of antiepileptic drugs in pregnancy does not appear to increase the risk for spontaneous abortion, according to an observational study in The BMJ.
Using Danish registries, researchers examined over 980,000 pregnancies from 1997 through 2008; 11% resulted in spontaneous abortion and 0.3% in stillbirth. Overall, 0.5% of pregnancies were exposed to antiepileptic drugs.
After multivariable adjustment, antiepileptic exposure was associated with a 13% increased risk for spontaneous abortion relative to nonexposure; however, the increased risk was significant only among women without epilepsy. In addition, when consecutive pregnancies discordant for antiepileptic use within the same woman were examined, antiepileptics were not associated with spontaneous abortion. The researchers conclude, therefore, that residual confounding may explain the increased risk observed in the main analysis.
Antiepileptics were not significantly associated with risk for stillbirth, although the researchers call the finding "imprecise."
Eleanor Bimla Schwarz of NEJM Journal Watch Women's Health commented, "This study highlights that the risks associated with untreated maternal disease in pregnancy are generally worse than those associated with maternal use of medication, especially for women with epilepsy."