Department of Medicine and Neurosciences, Royal Melbourne Hospital and University of Melbourne, Parkville, Vic., Australia.
Acta Neurol Scand. 2013 Oct;128(4):228-34. doi: 10.1111/ane.12115. Epub 2013 Mar 6.
To study associations between patterns of fetal malformation and individual antiepileptic drugs taken during pregnancy.
Multiple variable logistic regression and other statistical analyses of data relating to 1733 fetuses from 1703 pregnancies (147 of which were not exposed to antiepileptic drugs during pregnancy).
There were statistically significant (P < 0.05) associations between (i) valproate exposure and spina bifida, malformations of the heart and great vessels, digits, skull bones, and brain, but not hypospadias, cleft palate/lip and mouth abnormalities, (ii) topiramate exposure and hypospadias and brain maldevelopments, and (iii) carbamazepine (CBZ) exposure and renal tract abnormalities.
The valproate findings are mostly in keeping with the published literature, but the topiramate finding regarding hypospadias and the association between CBZ exposure and various renal tract abnormalities raise questions of organ specific teratogenesis. More extensive data are desirable, particularly in relation to topiramate, which is being used increasingly as a migraine prophylactic in women of childbearing potential.
研究胎儿畸形模式与孕期服用的个别抗癫痫药物之间的关联。
对 1703 例妊娠（其中 147 例未在孕期服用抗癫痫药物）中 1733 例胎儿的相关数据进行多变量逻辑回归和其他统计学分析。
（i）丙戊酸暴露与脊柱裂、心脏和大血管、手指、颅骨和大脑畸形有关，但与尿道下裂、腭裂/唇裂和口腔异常无关，（ii）托吡酯暴露与尿道下裂和大脑发育不良有关，以及（iii）卡马西平（CBZ）暴露与肾道异常有关，这些均具有统计学意义（P < 0.05）。
丙戊酸的研究结果与已发表的文献基本一致，但托吡酯与尿道下裂的关系以及 CBZ 暴露与各种肾道异常之间的关联提出了关于特定器官致畸性的问题。需要更广泛的数据，特别是关于托吡酯的，因为它作为一种潜在生育能力女性的偏头痛预防药物，使用越来越广泛。
