MedWire News: Children born to women with epilepsy or migraines who take the drug topiramate during pregnancy may be at increased risk of birth defects, research suggests.
Effective epilepsy treatment during pregnancy is crucial because seizures may cause harm to the developing foetus, explain Dr John Craig, from the Royal Group of Hospitals in Belfast, UK, and colleagues.
However, they add that although evidence suggests that a number of epilepsy drugs are associated with an increased risk of birth defects, few studies have evaluated the risks associated with taking topiramate during pregnancy.
To address this, the team studied information on 178 babies born to women who took topiramate alone or with other epilepsy drugs during pregnancy.
In total, 16 of the babies were born with major birth defects. Three of these babies had mothers who took topiramate only during pregnancy and 13 had mothers who took topiramate plus other epilepsy drugs.
Analysis revealed that the risk of cleft palates or cleft lips was 11 times higher among children born to women who took topiramate only or with other epilepsy drugs during pregnancy compared with the general population.
Furthermore, the risk of genital birth defects was 14 times higher among male babies born to women who took topiramate only or with other epilepsy medications during pregnancy compared with the general population.
"While our results are preliminary, they are relevant not only in dealing with women with epilepsy of childbearing years," explain Dr Craig and team in the journal Neurology.
"Topiramate is also licensed for use for migraine prophylaxis [prevention], an even more common condition which also occurs frequently in women of childbearing years.
"Monitoring pregnancies in women with migraine exposed to topiramate should therefore be encouraged."
However, they add that further, larger studies are needed to confirm the findings before recommendations can be made regarding the use of topiramate with and without other epilepsy drugs during pregnancy.