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Mindert eine Folsäuresubstitution die Teratogenität von Antiepileptika?

Eine Analyse derzeitiger Kenntnisse

Is the risk of congenital malformations induced by antiepileptic drugs reduced by folic acid supplementation? An analysis of current data

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Abstract

Population–based studies documented a decrease of congenital malformations (especially neural tube defects, NTD) in children of women who received a folic acid supplementation prior to pregnancy and during the first 2–3 months after conception. A daily dosage of folic acid of 0.4–0.8 mg was effective. In women who already had borne a child with a NTD a folic acid supplementation of 4 mg/day reduced the NTD–risk for further children significantly. However, current data do not indicate that the additional risk of congential malformations induced by antiepileptic drugs is reduced by the supplementation of folic acid.

Zusammenfassung

Populationsstudien in Ungarn und China haben gezeigt, dass die präkonzeptionell beginnende Folsäureergänzung in einer Tagesdosis von 0,4–0,8 mg das Risiko kindlicher großer Fehlbildungen (insbesondere von Neuralrohrdefekten, NTD) signifikant mindert. Die Folsäuregabe gleicht die ernährungsbedingt zu geringe Folsäure–Körperkonzentration aus. Bei Frauen, die bereits ein Kind mit einem NTD zur Welt gebracht hatten, minderte die präkonzeptionell beginnende Gabe von 4 mg Folsäure/ Tag das Fehlbildungsrisiko für weitere Kinder signifikant. Derzeit gibt es allerdings keine Hinweise darauf, dass die Folsäuregabe das zusätzlich durch Antiepileptika vermittelte Fehlbildungsrisiko reduziert.

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  1. Universitätsklinikum Bonn, Klinik für Epileptologie, Sigmund-Freudstr. 25, 53105, Bonn, Germany

    Eva Schmitt &  Jürgen Bauer

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  1. Eva Schmitt
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  2. Jürgen Bauer
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Correspondence to Jürgen Bauer.

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Schmitt, E., Bauer, J. Mindert eine Folsäuresubstitution die Teratogenität von Antiepileptika?. Z Epileptol 17, 199–208 (2004). https://doi.org/10.1007/s10309-004-0069-1

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