Facial anthropometric measurements in offspring of epileptic mothers

Background. Minor facial anomalies in 14-33% of exposed fetuses have been a ssociated with the teratogenic effect of antiepileptic drugs (AED) since 19 68. The purpose of this article is to describe the facial characteristics o f offspring of epileptic mothers with and without exposure to AED by means of 22 anthropometric measurements, for the purpose of comparison with the m easurements of offspring of non-epileptic women previously described in the literature, and to correlate the facial anomalies with the specific drug. Methods. An interval was defined where 95% of the central values were consi dered as "common values" and the remaining 5% as "uncommon values" (UV) or as being in the "alert zone"; the odds ratio with Wolf modification was use d and then Fisher's Lest for comparison with healthy newborns. Full-term eu trophic newborns of epileptic mothers who received attention at the epileps y clinic of a gyneco-obstetric center were included. Results. During the study period, 72 eutrophic, full-term newborns were inc luded; in 70 cases at least one measurement was found in the alert zone, wi th a predominance of the mid-line area. No differences were found between n eonates who received monotherapy vs. polytherapy. The groups exposed to phe nobarbital, clonazepam and multiple AED showed more uncommon values (p <0.0 5), identified as minor dysmorphisms by other authors, it seems to be a par ticular susceptibility of the mid-line of the face to show the effects of A ED and, additionally, of environmental agents. Conclusions. No differences were found in the facial values among the diffe rent AED used in monotherapy form. It is suggested that the choice of drug used during pregnancy must be decided on according to the clinical diagnosi s of each mother's epilepsy, and not on the basis of potential teratogenic risk. (C) 1999 IMSS. Published by Elsevier Science Inc.