Teratogene effekter av antiepileptika
DOI:
https://doi.org/10.5324/nje.v7i1.350Abstract
SAMMENDRAG
Ca. 1 av 200 gravide har epilepsi. Gravide med epilepsi har økt risiko for visse obstetriske komplikasjoner
og for å føde barn med medfødte misdannelser. Risikoen for misdannelser synes koblet til bruk av
antiepileptika under svangerskapet, og ikke til selve epilepsien. Alle typer misdannelser er økt, men leppeganespalte
og nevralrørsdefekter utgjør særlig viktige misdannelser. Årsakene til misdannelsene er multifaktorielle.
Bruk av antiepileptika i monoterapi kan sies å gi en individuell risiko for større misdannelser på
ca. 4-6%. Karbamazepin og natriumvalproat gir hhv. 0,5-1% og 2-3% risiko for nevralrørsdefekt. Samlet
risiko for større og mindre anomalier inkludert dysmorfe ansiktstrekk synes ikke å overstige 10%.
ENGLISH SUMMARY
Engelsen BA.
Teratogenic effects of antiepileptic drugs. Nor J Epidemiol 1997; 7 (1): 23-28.
Approximately 1 in 200 pregnant women have epilepsy, and 1 in 250 births are to children of mothers who
use antiepleptic drugs (AED). Pregnant women with epilepsy have increased risk for certain obstetrical
complications, and for giving birth to children with congenital malformations. The increased risk for
congenital malformations seems connected to the use of AED, not to the epileptic syndromes. The etiology
of congenital malformations are multifactorial. Use of AED in monotherapy is associated with an
individual risk of giving birth to a child with a major malformation of 4-6%. The specific risk of spina
bifida is 0,5 to 1% for carbamazepine and 2-3% for sodium valproate.
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