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Congenital malformations in the offspring of women with epilepsy: a two-decade experience in Poland Cover

Congenital malformations in the offspring of women with epilepsy: a two-decade experience in Poland

Open Access
|Dec 2025

Figures & Tables

The dose of ASM taken and the occurrence of major congenital malformations (MCMs)

ASM dose MSDMSDZpr
LTGNo MCM (N= 386)MCM (N = 27)
206.60248.38123.30212.78249.0791.06–0.260.7930.01
VPANo MCM (n = 279)MCM (n = 29)
154.53832.08405.21154.21815.52355.84–0.020.985<0.01
CBZNo MCM (n = 285)MCM (n = 21)
152.60759.470.00165.74791.670.00–0.670.5060.04
LEVNo MCM (n = 217)MCM (n = 13)
115.471792.40794.80116.081788.46900.50–0.030.974<0.01
OXCNo MCM (n = 127)MCM (n = 8)
68.461116.73507.1560.69993.75423.79–0.550.5820.05
TPMNo MCM (n = 70)MCM (n = 7)
39.36217.14112.1735.43210.71144.23–0.450.6510.05

Descriptive statistics of quantitative variables associated with pregnancy and the child

VariableMMeSDMin.Max.
Week of delivery – entire sample34.1539.0010.913.0048.00
Week of delivery – live births38.7439.002.012548
Apgar – entire sample9.5110.001.14110
Apgar – live births9.5110.001.13110
Length – entire sample53.5754.003.7226.0068.00
Length – live births53.6954.003.5626.0068.00
Weight – entire sample3271.703280.00553.07440.004860.00
Weight – live births3295.013300.00525.51450.004860.00

ASM use and major congenital malformations (MCMs)

Use of ASM No MCMMCMTotal
N%N%N%χ2pdfφ
LTGNo98471.7%6771.3%105171.6%0.010.9061< 0.01
Yes38928.3%2728.7%41628.4%
Total1373100.0%94100.0%1467100.0%
VPANo109179.5%6569.1%115678.8%5.600.02610.06
Yes28220.5%2930.9%31121.2%
Total1373100.0%94100.0%1467100.0%
CBZNo108479.0%7377.7%115778.9%0.090.7941<0.01
Yes28921.0%2122.3%31021.1%
Total1373100.0%94100.0%1467100.0%
LEVNo115684.2%8186.2%123784.3%0.260.76910.01
Yes21715.8%1313.8%23015.7%
Total1373100.0%94100.0%1467100.0%
OXCNo124690.8%8691.5%133290.8%0.061.0001<0.01
Yes1279.2%88.5%1359.2%
Total1373100.0%94100.0%1467100,0%
TPMNo130394.9%8792.6%139094.8%0.980.33410.03
Yes705.1%77.4%775.2%
Total1373100.0%94100.0%1467100.0%

Frequency of variables associated with epilepsy, pregnancy, and treatment

N%
Type of epilepsyFocal93863.9%
Generalised52936.1%
Folic acid intake prior conception (percentages without missing data)Yes84161.4%
No52838.6%
Tonic-clonic seizures in the first trimester (percentages without missing data)Yes15710.9%
No128689.1%
Mono/polytherapy in the first trimesterNo treatment19613.4%
Monotherapy101469.1%
Polytherapy25717.5%
Termination of pregnancy dependent on the gestational weekEarly miscarriage20914.2%
Late miscarriage161.1%
Premature birth1027.0%
Full-term birth113777.5%
Post-term birth30.2%
Pregnancy outcomeLive births123183.9%
Spontaneous miscarriage18512.6%
Induced miscarriage412.8%
Perinatal death100.7%
MCMNo137393.6%
Yes946.4%
MCM typeMultiple malformations1313.8%
Cardiovascular system3133.0%
Urogenital system2021.3%
Nervous system77.4%
Musculoskeletal system99.6%
Cleft palate55.3%
Eye-ear-face33.2%
Digestive system11.1%
Other non-specific55.3%

The most common drug combinations

Drug combinationsN%
LTG with VPA422.9%
LEV with LTG362.5%
CBZ with VPA201.4%
CBZ with LTG181.2%
CBZ with LEV141.0%
LEV with OXC120.8%
LEV with VPA100.7%
LTG with TPM100.7%
TPM with VPA90.6%
LTG with OXC80.5%
OXC with TPM70.5%
CBZ with TPM60.4%

ASM usage frequency and descriptive statistics of their doses

N%MSDMin.Max.
LTG41626.90%248.43121.3725.00700.00
VPA31120.10%830.52400.32150.002500.00
CBZ31120.10%761.16355.2750.001800.00
LEV23014.90%1792.17798.96200.004000.00
OXC1358.70%1109.44502.0775.002700.00
TPM775.00%216.56114.3225.00500.00
GBP140.90%1642.86848.27400.003600.00
VGB100.60%2125.00489.471500.003000.00
LCM90.60%322.22 100.00400.00
PHT80.50%264.29 50.00700.00
TGB50.30%27.00 15.0030.00
CLN50.30%2.50 0.506.00
PB40.30%70.00 30.00100.00
ESM40.30%625.00 500.001000.00
BNZ10.10%6.00 6.006.00
BRI10.10%300.00 300.00300.00
BZN10.10%5.00 5.005.00
CNB10.10%300.00 300.00300.00
PGB10.10%300.00 300.00300.00
PRM10.10%250.00 250.00250.00

Association between epilepsy type, folic acid intake, tonic-clonic seizures, and type of therapy with the occurrence of malformations in children

Variable No malformationsMalformationTotal
N%N%N%χ2pdfVc/φ
Type of epilepsyFocal87964.1%5962.1%93863.9%0.150.74110.01
Generalised49335.9%3637.9%52936.1%
Total1372100.0%95100.0%1467100.0%
Folic acid intake prior conceptionYes78761.5%5460.0%84161.4%0.080.8231<0.01
No49238.5%3640.0%52838.6%
Total1279100.0%90100.0%1369100.0%
Tonic-clonic seizures in the first trimesterYes15011.1%77.6%15710.9%1.090.38610.03
No120188.9%8592.4%128689.1%
Total1351100.0%92100.0%1443100.0%
Mono/polytherapy in the first trimesterNo treatment18913.8%77.4%19613.4%3.270.19520.05
Monotherapy94568.9%6972.6%101469.1%
Polytherapy23817.3%1920.0%25717.5%
Total1372100.0%95100.0%1467100.0%
DOI: https://doi.org/10.2478/joepi-2025-0001 | Journal eISSN: 2299-9728 | Journal ISSN: 2300-0147
Language: English
Page range: 3 - 10
Submitted on: Oct 20, 2025
Accepted on: Nov 21, 2025
Published on: Dec 10, 2025
Published by: The Foundation of Epileptology
In partnership with: Paradigm Publishing Services
Publication frequency: 2 issues per year

© 2025 Joanna Jędrzejczak, Beata Majkowska-Zwolińska, published by The Foundation of Epileptology
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Volume 33 (2025): Issue 1 (December 2025)