Association of prenatal phenobarbital and phenytoin exposure with genital anomalies and menstrual disorders

Background: Animal studies demonstrated that early exposure to phenobarbita l decreases reproductive function. This study investigates whether prenatal exposure to these anticonvulsants affects human genital tract development. Methods: Genital anomalies at birth were studied retrospectively in 90 phen obarbital-exposed, 108 phenobarbital plus phenytoin-exposed, and 198 matche d control infants. Of this group, 72 drug-exposed males, 75 drug-exposed fe males, and 147 matched control subjects participated in a follow-up and wer e interviewed at age 19-35. Differences between groups were tested by chi-s quare and t-tests. Results: A total of 15% of the phenobarbital-exposed boys versus 2.8% contr ol boys had undescended testes at birth. More anticonvulsant-exposed (24%) than control males (11%) had received medical treatment for genital anomali es. Anticonvulsant-exposed females more often had irregularities in menstru al cycles (31% vs 17%) and bleeding (15% vs 3%) and reported more problems during pregnancy. Conclusions: Prenatal exposure to anticonvulsants seems to induce minor gen ital anomalies and may affect reproductive function. (C) 2001 Wiley-Liss, I nc.