Original Article

Effect of antiepileptic drugs on serum biochemical marker levels of first and

second trimester screening tests

Berhan Besimoglu , Fatma Doğa Öcal, Selcan Sinaci, Ayşegül Atalay, Atakan Tanaçan, Dilek Şahin

First published: 12 April 2022

https://doi.org/10.1111/jog.15250

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Abstract

Objectives
Our aim in this study was to evaluate the effect of antiepileptic drugs on biochemical
components of screening tests.

Materials and Methods

This longitudinal case–control study was performed at Ankara City Hospital, Ankara, Turkey,
from June 2020 to January 2021. The case group included epileptic singleton pregnant
women which were using antiepileptic drugs, between 18 and 44 years of age. The control
group included healthy pregnant women between 18 and 44 years old who did not use any
drugs. Maternal medical, obstetric, and gynecological history were recorded. The
antiepileptic agents that are used in our study were; lamotrigine, levetiracetam,
carbamazepine, oxcarbazepine, valproic acid, and clonazepam. For the aneuploidy
screening program conducted in our laboratory, the biochemical markers that are analyzed
include; free b-hCG and PAPP-A in the first trimester, as well as AFP, HCG, and unconjugated
estriol (uE3) in the second trimester. MoM values of these markers were compared between
the case and control groups.

Results
Fifty-three pregnant women with epilepsy using antiepileptic drugs were compared with 106
healthy pregnant women. The levels of serum-free b-hCG, and PAPP-A were similar between
the case and control groups (p = 0.653, p = 0.351). For the second-trimester screening
biochemical markers, the maternal serum uE3 and AFP levels expressed as MoM were
significantly higher in the epileptic group than in the control patients (p = 0.015 and
p = 0.001).

Conclusion
Serum marker levels of second-trimester screening tests may be affected by antiepileptic
drugs, which may lead to misinterpretation of the risk level. Antiepileptic drug usage should
be considered when evaluating screening test results.
Open Research 

Data availability statement

The data that support the findings of this study are available from the corresponding author upon
reasonable request.

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