Abstract
Red cell folate concentrations were determined in 74 epileptic women in early pregnancy in a prospective study. All patients were treated continuously with antiepileptic drugs since before conception. The most frequently used drugs were carbamazepine (n−39) and phenytoin (n−26). Sixty-four patients (86%) were on monotherapy. Blood samples for red cell folate and antiepileptic drug concentrations were drawn before folate supplementation. Red cell folate levels in patients, 468 nmol·l−1, did not differ from those in non-epileptic, drug-free, pregnant women, 416 nmol·l−1 or from those in non-pregnant age-matched healthy controls, 412 nmol·l−1. No correlation was found between red cell folate concentrations and doses or plasma levels of phenytoin or carbamazepine.
Similar content being viewed by others
References
Bartels PC, Hellman PW, Soons JBJ (1989) Investigation of red cell size-distribution histograms related to folate, vitamin B12 and iron state in the course of pregnancy. Scand J Clin Lab Invest 49:763–771
Dansky LV, Andermann E, Rosenblatt D, Sherwin AL, Andermann F (1987) Anticonvulsants, folate levels, and pregnancy outcome: A prospective study. Ann Neurol 21:176–182
Dansky LV, Rosenblatt DS, Andermann E (1992) Mechanisms of teratogenesis: Folic acid and antiepileptic therapy. Neurology 42[Suppl 5]:32–42
Dellaportas DI, Shorvon SD, Galbraith AW, Laundy M, Reynolds EH, Marshall WJ, Chanarin I (1982) Chronic toxicity in epileptic patients receiving single-drug treatment. BMJ 285:409–410
Ek J, Magnus EM (1981) Plasma and red blood cell folate during normal pregnancies. Acta Obstet Gynecol Scand 60:247–251
Habibzadeh N, Schorah CJ, Smithells RW (1986) The effects of maternal folic acid and vitamin C nutrition in early pregnancy on reproductive performance in the guinea pig. Br J Nutr 55:23–35
Hansen HA (1964) On the diagnosis of folic acid deficiency. Almqvist and Wiksell, Stockholm
Hiilesmaa VK, Teramo K, Granström M-L, Bardy AH (1983) Serum folate concentrations during pregnancy in women with epilepsy: relation to antiepileptic drug concentrations, number of seizures, and fetal outcome. BMJ 287:577–579
Hoffbrand AV, Newcombe BFA, Mollin DL (1966) Method of assay of red cell folate activity and the value of the assay as a test for folate deficiency. J Clin Pathol 19:17–28
Kaneko S, Otani K, Fukushima Y, Ogawa Y, Nomura Y, Ono T, Nakane Y, Teranishi T, Goto M (1988) Teratogenicity of antiepileptic drugs: analysis of possible risk factors. Epilepsia 29:459–467
MRC Vitamin Study Research Group (1991) Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. Lancet 338:131–137
Nelson DA, Davy FR (1991) Erythrocytic disorders. In: Henry JB (ed) Clinical diagnosis and management by laboratory methods, 18th edn. Saunders, Philadelphia, pp 627–677
Ogawa Y, Kaneko S, Otani K, Fukushima Y (1991) Serum folic acid levels in epileptic mothers and their relationship to congenital malformations. Epilepsy Res 8:75–78
Reynolds EH (1973) Anticonvulsants, folic acid, and epilepsy. Lancet I:1376–1378
Reynolds EH (1983) Adverse haematological effects of antiepileptic drugs. In: Oxley J, Janz D, Meinardi H(eds) Antiepileptic therapy: chronic toxicity of antiepileptic drugs. Raven, New York, pp 91–99
Tomson T, Lindbom U, Ekqvist B, Sundqvist A (1994) Epilepsy and pregnancy: a prospective study of seizure control in relation to free and total plasma concentrations of carbamazepine and phenytoin. Epilepsia 35:122–130
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Tomson, T., Lindbom, U., Sundqvist, A. et al. Red cell folate levels in pregnant epileptic women. Eur J Clin Pharmacol 48, 305–308 (1995). https://doi.org/10.1007/BF00198317
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00198317