Is there Evidence for Vitamin K Prophylaxis in Pregnant Women taking Anticonvulsant Drugs?

Abstract

Purpose: The objective of this study was to examine the need of vitamin K prophylaxis in women with epilepsy (WWE) taking anticonvulsant drugs (AED) during pregnancy to prevent neonatal bleeding. Patients and methods: The study population (n=1037) consisted of two study groups: i) the epilepsy group including all neonates of WWE (n=51) taking AED of the Innsbruck EURAP register. Twenty-four of the 51 were taking enzyme-inducing AED (EIAED). ii) the control group of 986 newborns not exposed to AED. Results: The two study groups did not differ regarding hemorrhagic complications in newborns. None of the newborns of WWE taking AED showed neonatal bleeding. Hemorrhagic complications were more prevalent in newborns with low birth weight (p<0.01) and in multiple birth (p=0.02). Conclusion: Neonates exposed to AED, enzyme-inducing and non-enzyme-inducing, were not at a higher risk for hemorrhagic complications compared to unexposed newborns. Birth-weight and multiple birth - not AED - should be considered as risk factors of neonatal bleeding.