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EURAP

Das europäische Register für Schwangerschaften unter Antiepileptika

EURAP

The European Registry of Antiepileptic Drugs and Pregnancy

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Zusammenfassung

Alle konventionellen Antiepileptika (AED) gelten als teratogen. In Deutschland nimmt eine von 200 schwangeren Frauen (0,5%) wegen einer Epilepsie AED ein. Das Risiko für große Fehlbildungen nach AED-Exposition im 1. Trimenon ist 2- bis 3fach gegenüber dem allgemeinen Fehlbildungsrisiko, das bei etwa 2–3% liegt, erhöht. Eine zuverlässige Information über substanzspezifische teratogene Risiken ist deshalb von großer Bedeutung für die Beratung von epilepsiekranken Frauen mit Schwangerschaftswunsch. Leider sind die vorliegenden Daten zum relativen Risiko von AED widersprüchlich, primär aufgrund zu kleiner Fallzahlen und methodischer Schwächen der existierenden Studien. Die teratogenen Risiken der so genannten neuen AED sind bisher kaum untersucht, weshalb derzeit keine rational begründeten Empfehlungen zur optimalen AED-Therapie in der Schwangerschaft existieren. EURAP (europäisches Register für Schwangerschaften unter AED) ist eine internationale prospektive Studie zur Erfassung großer Fehlbildungen bei Schwangerschaften unter AED-Exposition. In Deutschland wurden seit Beginn des Projektes 2001 über 500 Schwangerschaften rekrutiert. Bei einer geschätzten Zahl von jährlich 4000 Schwangerschaften unter AED-Exposition in Deutschland liegt die Rekrutierungsrate aktuell bei 4%.

Summary

All old-generation antiepileptic drugs (AEDs) are considered to be teratogenic. In Germany, one out of 200 pregnant women (0.5%) is treated with AEDs for epilepsy. The risk of major malformations following exposure to AEDs during the first trimester of pregnancy is two to three times the rate reported in the general population, which is estimated at 2‒3%. The risks associated with the treatment of epilepsy during pregnancy are therefore of major concern to all women of childbearing potential with epilepsy. Data on the comparative teratogenicity of these AEDs in humans are, however, conflicting, mainly due to inadequate sample sizes and other methodological shortcomings of previous studies. The teratogenic potential of newer AEDs is even less well known, which prevents a rational approach to AED treatment in women of childbearing potential. The European Registry of Antiepileptic Drugs and Pregnancy is a prospective international multicentre study of pregnancies with AEDs. In Germany the project was started in 2001 and so far more than 500 pregnancies have been enrolled. The enrollment rate is 4% of 4,000 pregnancies with AEDs reported annually.

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Authors and Affiliations

  1. Abteilung für Neurologie, Charité, Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Deutschland

    R. Kretz, I. Coban, V. Gaus & B. Schmitz

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  1. R. Kretz
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  2. I. Coban
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  3. V. Gaus
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  4. B. Schmitz
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Correspondence to R. Kretz.

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Kretz, R., Coban, I., Gaus, V. et al. EURAP. Nervenarzt 77, 722–728 (2006). https://doi.org/10.1007/s00115-006-2082-2

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  • DOI: https://doi.org/10.1007/s00115-006-2082-2

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