Perinatal outcomes from the use of antiepileptic drugs during pregnancy: a case-control study

To evaluate the perinatal results from epileptic women using antiepileptic drugs during prenatal care.

This was a retrospective longitudinal study assessing the perinatal results of women exposed to antiepileptic drugs during pregnancy, and we compared these results with those of pregnant women who were not exposed. The development of pregnancy, gestational age at delivery, Apgar scores, biometric data, morbidity, stillbirths and neonatal mortality were analyzed. The chi-square test and Fisher's exact test were used for the categorical variables, while Student's t-test was used for independent numerical variables.

Over a 10-year period, 12 790 singleton gestations were analyzed, among which 104 (0.8%) consisted of epileptic pregnant women. From this total, 82 evolved to childbirth and their neonatal data were compared with those of 316 newborns from non-epileptic women. The most-used antiepileptic drug was phenobarbital in 70% of the cases. There was greater neonatal mortality (p = 0.006), occurrence of neonatal hemorrhagic disorders (p = 0.005), and occurrence of minor congenital anomalies (p = 0.03) among the children of women exposed to antiepileptic drugs.

The antenatal exposure to antiepileptic drugs is associated mainly with occurrences of hemorrhagic complications during the neonatal period; furthermore, great prevalence of newborns presenting minor congenital anomalies and elevated risk of neonatal mortality.