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Genetics of the Epilepsies pp 175–183Cite as

Genetic Variability in Fetal Response to Anticonvulsants

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Abstract

Since the discovery of thalidomide embryopathy in 1961, many other drugs and chemicals have been recognized as potential teratogens. Observations during the last three decades have shown that thalidomide is still the strongest teratogen, causing malformations in 20%–50% of fetuses that are exposed during the critically sensitive embryonic period [20]. Only the retinoic acid congeners isotretinoin and etretinate and the obsolete trimethadiones induce severe anomalies in a similarly large proportion of exposed fetuses [13, 26, 31]. Most other teratogenic drugs are associated with malformations in a much smaller proportion of exposed fetuses. This is also the case with the anticonvulsant drugs phenytoin, phenobarbitone, primidone, valproate, and carbamazepine. The use of these drugs during the first trimester of pregnancy is associated with, on the average, a twofold risk of congenital malformation. High maternal serum levels of the parent drug seem to be of some significance [4, 12], but they cannot explain by themselves the occurrence of malformations because many unaffected infants were born after documented exposure to equally high maternal drug levels.

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Author information

Authors and Affiliations

  1. Department of Clinical Genetics, Erasmus University, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands

    D. Lindhout

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  1. D. Lindhout
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Editor information

Editors and Affiliations

  1. Neurologische Abteilung, Universitätsklinikum Rudolf Virchow, Freie Universität Berlin, Spandauer Damm 130, D-1000, Berlin 19, Germany

    Gertrud Beck-Mannagetta M.D. (Assistant Professor of Neurology) & Dieter Janz M.D. (Professor of Neurology) (Assistant Professor of Neurology) &  (Professor of Neurology)

  2. Dight Laboratories, University of Minnesota, 400 Church Street S.E., 55455, Minneapolis, MN, USA

    V. Elving Anderson M.D. (Professor of Genetics and Cell Biology) (Professor of Genetics and Cell Biology)

  3. Abteilung für Neuropädiatrie, Universität Kiel, Schwanenweg 20, D-2300, Kiel, Germany

    Hermann Doose M.D. (Professor of Pediatrics) (Professor of Pediatrics)

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© 1989 Springer-Verlag Berlin Heidelberg

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Lindhout, D. (1989). Genetic Variability in Fetal Response to Anticonvulsants. In: Beck-Mannagetta, G., Anderson, V.E., Doose, H., Janz, D. (eds) Genetics of the Epilepsies. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-95553-2_22

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  • DOI: https://doi.org/10.1007/978-3-642-95553-2_22

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-95555-6

  • Online ISBN: 978-3-642-95553-2

  • eBook Packages: Springer Book Archive

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