Epilepsy, anticonvulsants and congenital malformations.

Abstract

The dysmorphogenic potential of the anticonvulsant drug phenytoin in laboratory animals has been known for a number of years. In 1968 an association was noted between the occurrence of congenital abnormalities in man, particularly cleft lip with or without cleft palate, and the use of anticonvulsant drugs during pregnancy. Since then a number of surveys into the outcome of pregnancy in epileptic women have shown that there is an increased incidence of malformations in the children. This incidence has varied in the different reports from 15 % to 4 %, with an average incidence recorded in 9 major surveys of 7 %. The risk of an epileptic woman having a malformed baby has been estimated by most authors to be 2 to 3 times greater than in the general population. The most common malformations have been cleft lip with or without cleft palate and congenital heart disease, and it seems possible that these 2 types of malformations may occur together much more often than has previously been reported. A wide variety of other abnormalities involving most of the major organ systems of the body have also occurred.