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Cohort study
Babies exposed to newer-generation antiepileptic drugs (compared with no antiepileptic drug exposure) in the first-trimester of pregnancy are not at increased risk of major birth defects
  1. Jose F Tellez-Zenteno
  1. Department of Medicine, Division of Neurology, University of Saskatchewan, Saskatoon, Canada
  1. Correspondence to Jose F Tellez-Zenteno
    Department of Medicine, Division of Neurology, University of Saskatchewan, Room 1622, B Wing, Box 26, 102 Hospital drive, Saskatoon, Saskatchewan S7N 0W8 Canada; jft084{at}mail.usask.ca

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Context

In the last few years, more information has been published regarding birth defects associated with the use of the new generation of antiepileptic drugs (AEDs). Some recent reports from different registries have shown a lower rate of major birth defects associated with the use of new generation AEDs compared with some of the first-generation AEDs. For example, an Australian registry showed no increase in major birth defects with the use of lamotrigine in the first trimester.1 But a North American registry reported a significant increase in the presence of oral clefts in infants exposed to lamotrigine during pregnancy, in contrast with a European registry which showed no association between rate of birth defects and the use of lamotrigine.2 3 Another study from Finland reported no increase in the rate of congenital malformations with the use of oxcarbazepine.4

Methods

Molgaard-Nielsen et al published a new study exploring the rate of birth defects associated with the use of some of the new AEDs. This study was based on the Danish medical birth registry. The study included 837 795 live born infants from January 1, 1996 through September 30, 2008. The patient information included in the registry …

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