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New fear over drug threat to babies.

Byline: Jenny Hudson

Hundreds of mothersto-be have been caught up in a health scare involving a drug which can pose a serious threat to their unborn babies.

The alert surrounds powerful medicines used to control epilepsy which are routinely prescribed to pregnant women.

Some combinations of medication carry a 50 per cent risk of causing serious problems such as birth defects and learning difficulties, according to new figures from Birmingham specialists.

But doctors are continuing to prescribe anti-convulsants known to have a significantly higher risk of causing harm.

The majority of women referred to the University of Birmingham's Seizure Clinic have not been advised on changing their medication.

And many women are taking anti-convulsants even though they do not have epilepsy. Fifteen per cent of patients referred to the Seizure Clinic have been misdiagnosed.

Dr Tim Betts and Lyn Greenhill, who run the service at the Queen Elizabeth Psychiatric Hospital, are calling for urgent action to address the 'fragmented' system which is failing many mothers and their babies.

They say the medical profession has failed to act on concerns about the effect of anticonvulsants first raised 15 years ago and the evidence which has since emerged.

However they emphasise women should not panic and stop taking their medication, but seek immediate advice. Epilepsy is the second most common cause of maternal death in pregnancy.

Specialists at the clinic analysed two groups of 100 patients. Among the group who had continued to take the same anticonvulsant drugs throughout their pregnancies, 18 babies had serious abnormalities.

The other group had their anticonvulsant drugs changed before conception and took folic acid throughout pregnancy. There were no cases of birth abnormalities.

This summer, the UK Pregnancy Register's five-year study of all babies born to women with epilepsy is expected to uncover the full extent of the drug-related birth defects. It is expected to become a major public health scandal.

One in 100 people has epilepsy and 40 per cent of them are women of child bearing age.

The seizure clinic at the QEPH provides the UK's only dedicated service for pregnant women who have epilepsy.

The clinic has found the most serious birth defects were in babies born to mothers who had been taking a combination of three different anti-convulsant drugs.

A commonly used combination of drugs carries a 50 per cent risk of causing deformities. Problems include spina bifida, or malformation of the spinal cord and spine, serious cardiac defects such as a hole in the heart, cleft palate and hare lip and limb deformities.

Dr Betts, a consultant neuropsychiatrist, said there is also evidence of a connection between anti-convulsant drugs and learning disorders.

'There is a significant link to psychological damage later down the line, including the autistic spectrum. The problem is these children have not been followed up five years down the line.'

The clinic warns sodium valporate, a drug which is widely used by women of child-bearing age, is 'high risk' and should be avoided around conception and during pregnancy.

However, the risk can be reduced by lowering the dose and even if a single drug is 'high risk', the majority of offspring will be safe, the specialists said.

Dr Betts said: 'There is a lot of anger that people have been misinformed and mislead and that the medical profession has not taken on board concerns first raised 15 years ago.

'The thing that distresses us is that most of the pregnant women we see have not been advised on epilepsy drugs.'

Mrs Greenhill, a nurse practitioner in epilepsy working for South Birmingham Mental Health Trust said women with epilepsy should seek advice before they try to conceive.

If a woman changes her medication only after discovering she is pregnant, the damage will have already been done.
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Publication:The Birmingham Post (England)
Date:Jan 21, 2002
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