Foetal malformation risk high in ART-conceived pregnancies of women with epilepsy

Conception via assisted reproductive technology (ART) carries an increased risk of foetal malformation among women with epilepsy, according to a study.

Researchers used data from the Australian Pregnancy Register of Antiepileptic Drugs concerning the pregnancies of women with antiseizure medication-treated epilepsy. Standard simple statistical methods were used in the analysis.

Results showed that foetal malformation occurred with significantly greater frequently among pregnant women with epilepsy who received antiseizure medications than among those who were untreated in at least the earlier months of pregnancy (p<0.05).

Notably, the risk of malformation was more pronounced when the pregnancy had been initiated via ART (n=152) than when ART was not involved (n=2,388) (11.18 percent vs 6.49 percent; relative risk [RR], 1.72, 95 percent confidence interval [CI], 1.07–2.77). This risk remained high when compared with those in non-ART pregnancies in women treated with antiseizure medication (n=2,191) (11.18 percent vs 6.79 percent; RR, 1.64, 95 percent CI, 1.02–2.64).

The anatomical sites affected by the malformations also varied, such that heart and great vessels abnormalities occurred more commonly in pregnancies involving ART.

In multivariate logistic regression, the increased malformation risk associated with ART plus antiseizure medication exposure appeared to be driven by the use of hormones in ART more than by in vitro fertilization.

The findings highlight the importance of awareness of foetal malformation risk in ART-conceived pregnancies beyond that associated with antiseizure medication exposure.