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Epilepsy drugs linked to spina bifida

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Pregnant women taking common epilepsy drugs face an increased risk of delivering a baby with spina bifida, according to the findings of a systematic review.

Past studies showed a link between the condition and the medicines valproic acid and carbamazepine.

The link has now been confirmed in a systematic review involving more than 3.8 million births published in the British Medical Journal (BMJ).

A team led by Professor Lolkje de Jong-van den Berg, from the University of Groningen in the Netherlands, looked for evidence of major malformations linked to carbamazepine use in the first three months of pregnancy. Valproic acid and carbamazepine are used to treat epilepsy and some mental health problems, such as bipolar disorder and schizophrenia.

Spina bifida was the only one noted but was 2.6 times more likely in babies born to women who had taken carbamazepine, compared with those not taking any anti-epileptic drug. But they said it carried smaller risks than valproic acid, which was also included in some of the studies.

The experts concluded: “Although most anti-epileptic drugs taken during pregnancy significantly increase the risk for one or more specific foetal malformations, the occurrence of these malformations is nevertheless rare. Most exposed pregnancies result in a baby without malformation.

“The best option regarding anti-epileptic drug treatment can be chosen only on an individual basis by the woman and neurologist before pregnancy, weighing the benefits of epilepsy control against the risk.”

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