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Seizures, Anticonvulsants, and Pregnancy

DAVID A. STUMPF, MD, PhD; MICHAEL FROST, MD
Am J Dis Child. 1978;132(8):746-748. doi:10.1001/archpedi.1978.02120330018002.
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The Journal has been the forum for previous comments about anticonvulsant teratogenicity.1,2 High risks are associated with trimethadione.3 The risks associated with other anticonvulsants are less and need to be weighed against the hazards of epilepsy during pregnancy. The conclusion that phenytoin induces serious anomalies in 10% of the offspring of epileptics and less major abnormalities in 30%2 is not supported by the bulk of the literature. The recommendation to discontinue such medication in treated epileptics appears unwarranted.

MALFORMATIONS IN CHILDREN OF EPILEPTICS  Most studies are in agreement that epileptic mothers receiving anticonvulsants are two to three times more likely to have malformed infants than mothers who never had a seizure.4-13 A number of studies indicate that the incidence of anomalous infants is the same in treated and untreated epileptics.4-6.14 Others find a greater number of anomalies in treated epileptics compared with untreated patients,8,12,13

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