Evaluation of drug therapy and teratogenic risk in a Rhône-Alpes district population of pregnant epileptic women

The authors describe a sample of 148 pregnancies in identified epileptic women from 2 distinct sources: questionnaires sent to a group of women, 15–45 years old, having had an EEG between 1976 and 1983, and a computerized registry involving all pregnancies occurring in 3 maternity wards in Lyon between 1979 and 1983. The analysis of drug therapy during early pregnancy showed that the most common regimen was monotherapy. Either in mono- or in polytherapies, phenobarbitone was the drug used most often, the second being valproic acid (67 and 25% of monotherapies, respectively). The epileptic mothers were younger than the controls, and had had fewer pregnancies. Sex and birthweight distribution did not differ from those of the controls. Twenty-six malformed infants (17.7%) were registered. Among them, 18 (70%) had minor defects only. No major malformation was observed in the ‘no drug’ group, 6.7 and 7.7% of major malformations were observed in the monotherapy and polytherapy groups, respectively.