Oxcarbazepine in pregnancy: clinical experience in Argentina

Effect of anti-epileptic drugs in pregnancy and teratogenesis

“…The findings of the complications during pregnancy and its outcome are controversial. Some studies have shown increase in seizures during pregnancy with epilepsy(6,7) while some studies have shown no increase in seizure during pregnancy and perpeurim (8).Chances of risk with AEDs are more, the risk being higher with polytherapy as compared to monotherapy (14)(15)(16)(17). Sodium valporate either as monotherapy or as poly therapy increases the risk of foetal malformations (13,18).…”

“…Monotherapy was found to reduce the overall prevalence of malformation, as the additive teratogenic effects of AED (polytherapy) are considerably reduced (14)(15)(16)(17). Teratogenic effect of AED may be mediated by the formation of free radicals or by antifolate effects.…”

“…The risk of malformation being higher in women on polytherapy as compared to monotherapy (14)(15)(16)(17). Excess risk was seen in patients using sodium valproate either as monotherapy or sodium valporate on poly therapy (13,18), higher doses implicate with increased risk.…”

Management of Epilepsy and Pregnancy

“…According to a recent re port on 55 pregnancies with OXB (35 monotherapy), one mal formation (cardiac) was observed in the offspring of a patient receiving the combination of OXB and PB and none with OXB monotherapy. [39] In a series of 309 infants (from six countries) exposed to OXB (248 as monotherapy), the malformation rates were 2.4% for monotherapy and 6.6% for the adjunctive therapy group. The relative risk of malformation for OXB monotherapy appeared to be comparable with that in community.…”

Epilepsy and Anticonvulsant Therapy During Pregnancy

“…Data from Argentina register revealed 35 pregnancies exposed to oxcarbazepine in mono-therapy resulted in the delivery of healthy infants. Of the 20 pregnancies exposed to oxcarbamazepine in combination with other AEDs only one malformed child was reported: a cardiac malformation in a newborn exposed to phenobarbital and oxcarbamazepine (Meischenguiser et al, 2004). An analysis of 248 published pregnancies involving maternal exposure of oxcarbamazepine in mono-therapy and 61 in poly-therapy did not find an increased incidence of malformations in exposed infants.…”