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Abstract Details

Trends In The Anti-Epileptic Drug Usage During Pregnancy And Malformation Outcomes Over Two Decades In Kerala Registry Of Epilepsy And Pregnancy
Epilepsy/Clinical Neurophysiology (EEG)
P2 - Poster Session 2 (5:30 PM-6:30 PM)
6-003

To determine trends in anti-epileptic drug (AED) use and malformation rate over two decades in the Kerala registry of Epilepsy and Pregnancy (KREP).

Observational data on AED usage and pregnancy outcome over the past two decades have shown the relative risk for major congenital malformations (MCM) of different AEDs and its dose dependency. 

This registry had been prospectively following up pregnancies in women with epilepsy and screening for MCM since 1998. In the present study, AED usage and the MCM rate for all completed pregnancies with a known outcome enrolled in this registry between 1998 and 2018 were analysed. Changes in usage of AEDs and MCM rate were analysed in blocks of five years.

2389 pregnancies were included in the study. Overall MCM rate was 5.8% (N=139). Change in use of AEDs from block 1 to block 4 was significant (p<0.001) for: phenobarbitone (39% to 5.9%), phenytoin (40.2% to 4.7%), valproate (27% to 10.6%), oxcarbazepine (0.7% to 25.5%), levetiracetam (0 to 45.6%) and clobazam (6.3% to 29.3%). Other AEDs such as lamotrigine (12.1% to 17.2%) and topiramate (8.3% to 22.2%) showed increasing trend, though number of exposures was limited to ascertain statistical significance. The overall MCM rates over two decades had reduced from 28.1% to 10.8%, though it was not statistically significant.

There was a trend for preferential use of newer AEDs and avoidance of valproate and other older drugs.  These changes in the AED preferences are not reflected in a significant reduction of MCM rates. 
Authors/Disclosures
Ravish Keni
PRESENTER
No disclosure on file
No disclosure on file
Sankara Sarma No disclosure on file
Sanjeev V. Thomas, MD, FAAN (Institute for Communicative and Cognitive Neurosciences) Dr. Thomas has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Wiley India. The institution of Dr. Thomas has received research support from Government of India.