Connect
MJA
MJA

The rationale for pregnancy registers for women with epilepsy

Frank J E Vajda, Terence J O’Brien, Cecilie M Lander and Mervyn J Eadie
Med J Aust 2011; 195 (1): . || doi: 10.5694/j.1326-5377.2011.tb03179.x
Published online: 4 July 2011

Promising outcomes from the Australian register include a fall in fetal malformation rates associated with changes in antiepileptic drug prescribing

The burden of epilepsy for those with the disorder is significant. For women of childbearing age, the uncertainty surrounding their ability to bear children who are free of the disorder, without birth defects, and cognitively and psychologically normal adds to this burden. Although factors other than medication exposure influence these questions, there is no doubt that antiepileptic drugs (AEDs) used to prevent seizures, such as valproate, have a significant, and possibly preventable, role in teratogenicity.1 Pregnancy registers are now showing promising results in elucidating this role and influencing changes in practice for the benefit of women with epilepsy and their children.


  • 1 Royal Melbourne Hospital and University of Melbourne, Melbourne, VIC.
  • 2 Royal Brisbane and Women’s Hospital and University of Queensland, Brisbane, QLD.
  • 3 Central Clinical School, University of Queensland, Brisbane, QLD.


Correspondence: vajda@netspace.net.au

Acknowledgements: 

We acknowledge the support of our medical and non-medical colleagues for referring patients to, and increasing awareness of, the Australian Pregnancy Register. We thank the scientific advisory board and the human research ethics committees of St Vincent’s Hospital, Monash Medical Centre, Royal Melbourne Hospital and other institutions. The Register is indebted for support to the Royal Melbourne Hospital Neuroscience Foundation, Epilepsy Society of Australia, Epilepsy Foundation of Victoria, and Epilepsy Australia and for generous financial support from the pharmaceutical industry, including sanofi-aventis, UCB Pharma, Janssen-Cilag, Novartis and Pfizer, and earlier support from Glaxo.

Competing interests:

Cecilie Lander has been paid by multiple companies to give lectures.

  • 1. ten Berg K, Lindhout D. Antiepileptic drugs in pregnancy: options for the prevention of congenital abnormalities. Community Genet 2002; 5: 40-49.
  • 2. Eadie MJ. Antiepileptic drugs as human teratogens. Expert Opin Drug Saf 2008; 7: 195-209.
  • 3. Vajda FJE. Treatment options for pregnant women with epilepsy. Expert Opin Pharmacother 2008; 9: 1859-1868.
  • 4. Tomson T, Battino D, Beaussart M, et al. A European registry of antiepileptic drugs and pregnancy. EURAP: aims, methods and organisation. Epilepsia 2000; 41 (Suppl Florence): 141.
  • 5. Vajda FJ, O’Brien TJ, Hitchcock A, et al. The Australian registry of anti-epileptic drugs in pregnancy: experience after 30 months. J Clin Neurosci 2003; 10: 543-549.
  • 6. Vajda FJ, O’Brien T, Hitchcock A, et al. The internal control group in a register of antiepileptic drug use in pregnancy. J Clin Neurosci 2008; 15: 29-35.
  • 7. Vajda FJ, Hitchcock AA, Graham J, et al. The teratogenic risk of antiepileptic drug polytherapy. Epilepsia 2010; 51: 805-810.
  • 8. Vajda F, Graham J, Roten A, et al. Is valproate (VPA) an obligatory teratogen, or is it just a matter of dose? Proceedings of the 4th World Congress on Controversies in Neurology; 2010 Oct 28–31; Barcelona, Spain.
  • 9. Vajda FJE, Graham JJ, Roten A, et al. Report on the second generation of antiepileptic drugs: from the database of the Australian Pregnancy Register. Proceedings of the 8th Asian & Oceanian Epilepsy Congress; 2010 Oct 21–24; Melbourne, Australia.
  • 10. Vajda FJE, Horgan D, Hollingworth S, et al. The prescribing of antiepileptic drugs for pregnant Australian women. Aust N Z J Obstet Gynaecol 2011. In print.
  • 11. Vajda FJ, Hollingworth S, Graham J, et al. Changing patterns of antiepileptic drug use in pregnant Australian women. Acta Neurol Scand 2010; 121: 89-93.

Author

remove_circle_outline Delete Author
add_circle_outline Add Author

Comment
Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Online responses are no longer available. Please refer to our instructions for authors page for more information.