Lowering epilepsy drug dose can cut risk of birth defects
“For many women on epilepsy medication, the desire to start a family can be fraught with fear that they could have a baby with a range of disabilities or malformations,” study’s lead researcher, Professor O’Brien, Royal Melbourne Hospital epilepsy specialist and Head of the Department of Medicine at The University of Melbourne, said.
“Previous studies have shown a strong relationship between the dose of valproate taken and the risk of the child having a birth defect. However, for many women valproate is the only drug that will help control their seizures.”
But now researchers have found that by reducing the dose of the drug taken in the first trimester of pregnancy can significantly cut the risk of having a baby with physical birth defects like spina bifida and hypospadias.
As both, spina bifida and hypospadias birth defects occur in the first three months of pregnancy, altering the dose of the drug can help, researchers averred.
While spina bifida, birth defect of the spine and spinal cord, is incurable, hypospadias, a birth defect of the penis, can be treated with surgery.
For the purpose of the study, researchers used Australian Pregnancy Register (APR) to randomly identify 1,700 pregnant women with epilepsy.
Researchers found that nearly 80 percent of the babies born with spina bifida had been exposed to high does of valproate in the first trimester.
Interestingly, high the dose, higher was the risk of defect.
Researchers observed that lowering the dose of the drug to the minimum possible strength during the first trimester of pregnancy helped bestow protective effects against both, women’s seizures and risk of the two birth defects.
“This evidence now tells us that by using valproate in the lowest dose that can control severe seizures may reduce the hazard of one of the most devastating birth defects,” Professor O’Brien wrote. The findings of the study are reported in the journal American Academy of Neurology.