Resumen
OBJETIVO: establecer si el riesgo de desarrollar defectos del tubo neural es mayor en hijos de embarazadas que, por cualquier razón, reciben ácido valproico si se compara con los hijos de mujeres que toman carbamazepina o con los hijos de las mujeres de la población general.
MATERIALES Y MÉTODOS: se hizo una revisión exhaustiva de bases de datos como MEDLINE, EMBASE, SCISEARCH, the Cocrane Library y LILACS, desde enero de 1966 y agosto de 2004. Se incluyeron estudios observacionales analíticos que buscaran la presencia de defectos del tubo neural en los hijos de madres expuestas a ácido valproico o carbamazepina durante el embarazo. Para cada estudio se hicieron tablas de 2x2 se calcularon riesgos relativos, razones de disparidad e intervalos de confianza del 95%.
RESULTADOS: se encontró un RR=0,61 (IC 95%) (0,06-6,72) de desarrollar defectos del tubo neural para quienes están expuestos a ácido valproico en monoterapia; en el caso de la carbamazepina el RR=1,10 (IC 95% 0,16-7-75).
CONCLUSIONES: los resultados obtenidos no ofrecen la evidencia suficiente para establecer el riesgo de desarrollar defectos del tubo neural por la exposición al ácido valproico o a la carbamazepina durante la gestación.
Citas
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