Abstracts

Potential for AED-related teratogenicity is a concern in the management of pregnancy in women with epilepsy. AEDs with documented teratogenic potential include older AEDs such as valproate (VPA), Phenobarbital (PB), phenytoin (PHT) and carbamazepine (CBZ). Less is known about the newer AEDs, but recent data suggests that lamotrigine may be safer than VPA or PB [1,2]. The present study was performed to ascertain the pattern of AED prescribing to pregnant women with epilepsy in a non-academic, community setting. We ascertained the pharmacy database of a community hospital in the Maryland suburbs of Washington, D.C. for all AEDs prescribed in 2003 to women with epilepsy at the time of delivery. The hospital, Holy Cross Hospital, has the largest obstetrical service in the state of Maryland. The database was searched by diagnostic codes for parturition and epilepsy. All women who delivered in the hospital and had AEDs dispensed by the hospital pharmacy were included. The data was reducted in order to delete all demographic identifiers. There were 7153 deliveries during the year 2003. 25 women with epilepsy received AEDs at the time of delivery (0.35% of all deliveries). In the order of frequency, the AEDs used were phenobarbital, 6/25 (24%), phenytoin, 6/25 (24%), valproate, 5/25 (20%), carbamazepine, 3/25 (12%), gabapentin, 3/25 and fosphenytoin, 2/25. AEDs with significant teratogenic potential such as valproate and phenobarbital are commonly prescribed during pregnancy in non-academic, community setting. More education of community physicians concerning pregnancy and epilepsy is needed.