The UK Epilepsy and Pregnancy Register
is a prospective, observational, registration
and follow-up study. Its aim is to determine
the comparative risk of major congenital
malformations (MCMs) such as facial clefts
or cardiac defects in children caused by
their mothers taking antiepileptic drugs
(AEDs) during pregnancy.
Women with epilepsy who become pregnant,
whether or not they were taking antiepileptic
drugs (AEDs), in any combination, and whose
details are forwarded before the outcome
of the pregnancy is known, have been included
in the study.
The Register has been operational since
1996 and was a recipient of a £46,000
grant from the Epilepsy Research Foundation in 2001. The study's
latest findings relate to 3,607 pregnancies
for which there was full outcome data on
31st March 2005.
The good news arising form the study is
that almost 96% of live births born to women
with epilepsy did not have a MCM.
However taking more than one AED (polytherapy)
increased the risk of a MCM and polytherapy
regimes containing sodium valproate (epilim)
had significantly more MCMs. A combination
of valproate and lamotrigine (lamictal)
carries the greatest risk (9.6%)
For women taking on one AED, the MCM rate
was lowest with carbamazepine (tegretol)
at 2.2% and greatest in those on valproate
6.2%. The risk increased further to 9.1%
with a daily dose of valproate exceeding
1000mg. The MCM rate with lamotrigine also
increased noticeably if the daliy dose exceeded
200g.
We are extremely pleased that research
we have helped fund is producing such important
findings that will help women with epilepsy
make important choices about their medication
during pregnancy.
There is clearly a need to continue to
collect data so that we can estimate the
risks that all available AEDs carry. If
you would like to join the Register, you
can do so via the freephone number 0800
389 1248 or via the UK
Epilepsy and Pregnancy Register website.
