Studies done on the general population have shown that folic acid supplementation during pregnancy may reduce the risk of neural tube defects (NTDs) and other major congenital malformations (MCMs).
Many doctors recommend that pregnant epileptic women start on a folic acid regiment, for folic acid has shown to reverse the antifolate effects that come from taking antiepileptic drugs (AEDs). The goal of a recent study by J.I. Morrow, et al. published in The Journal of Neurology, Neurosurgery and Psychiatry (2009) was to determine the effectiveness of starting a folic acid regiment. The study was both an observational and follow-up study, and women who qualified to be in this study were pregnant epileptic women who were referred before the outcome of the pregnancy was known. Malformation type, drug groups, and folic acid exposure were compared to the most commonly used monotherapy antiepileptic drugs.
Author Morrow JI. From the department of Neurology, Royal Group of Hospitals, Belfast, UK, explains the results of her experiment, which is called “Folic Acid use and Major Congenital malformations in Offspring of Women with Epilepsy: A Prospective Study from the UK Epilepsy and Pregnancy Register”. She states that “In 1935 cases reported to have received preconceptual folic acid, 76 MCMs (3.9%; 95% CI 3.1 to 4.9) and eight NTDs (0.4%; 95% CI 0.2 to 0.8) were identified. For 2375 women who were reported to have received folic acid but not until later in the pregnancy (n = 1825) or not at all (n = 550), there were 53 outcomes with an MCM (2.2%; 95% CI 1.7 to 2.9) and eight NTDs (0.34%; 95% CI 0.2 to 0.7).”
Conclusions from this study show that results from other general population studies on folic acid and women with epilepsy may be questionable, and that it is possible that the major congenital malformations observed and the increased risks that come from AEDs may occur for a different reason, other than folic acid deficiency in the body.
Whatever the case may be, this study clearly shows the risk for major congenital malformations associated with in utero exposure to antiepileptic drugs, particularly those containing sodium valproate, such as Depacon Depakene, and Depakote, (of Abbott Laboratories).
Because many women used drugs such as Depacon during pregnancy and were not informed of the risks for birth defects associated with Depacon, a number of Depacon lawsuits have been filed.
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