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KMID : 0358420090520121245
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Korean Journal of Obstetrics and Gynecology
2009 Volume.52 No. 12 p.1245 ~ p.1251
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Pregnancy outcomes in women with epilepsy using lamotrigine
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Lee Maria
Nam Ka-Hyun
Kwon Ja-Young
Park Yong-Won
Kim Young-Han
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Abstract
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Objective: The purpose of this study was to investigate pregnancy outcomes in women with epilepsy using lamotrigine (LTG).
Methods: We retrospectively reviewed the medical records of all patients who had been diagnosed as epilepsy and gave live singleton births in Yonsei University Health System, Seoul, Korea, between February 1996 and December 2007. Nine patients who were not taking antiepileptic drugs (AEDs) were excluded from this study. We subdivided the enrolled patients into 2 groups; patients exposed to LTG and others exposed to other AEDs. Congenital malformation, spontaneous abortion, small for gestational age, termination of pregnancy, intrauterine fetal death, preterm delivery, and adverse maternal outcomes were documented to evaluate the pregnancy outcomes. The statistical significance was defined as P<0.05.
Results: 129 cases were found in all medical records. The overall risk of congenital malformations in the AED group was 6.2% (n=8), which included 4 cases to carbamazepine (CBZ) monotherapy, 1 to valproate (VPA) monotherapy, and 3 to VPA+CBZ polytherapy. Congenital malformations were significantly increased in the non- LTG groups than in the LTG group (8.7% vs. 0%, P=0.047), especially in non-LTG polytherapy group (20.0% vs. 0%, P=0.049). The rates of spontaneous abortion, small for gestational age, termination of pregnancy, intrauterine fetal death, preterm delivery, and adverse maternal outcomes were no significant differences between the two groups.
Conslusion: This study demonstrates that administration of LTG in pregnant women with epilepsy could be more effective in decreasing teratogenicity than administration of other AEDs in polytherapy.
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KEYWORD
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Epilepsy, Antiepileptic drug, Pregnancy outcomes, Lamotrigine
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