Do newborns of epileptics on anticonvulsants develop biochemical signs of osteomalacia?

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Abstract
In a controlled prospective study performed in 16 pregnant epileptics and 9 normal pregnant controls, biochemical indices of Ca homeostasis (serum Ca, serum Mg, serum phosphate and serum alkaline phosphatases) were determined after 18 wk of pregnancy, at birth, 8 days and 6 mo. after birth. The same indices were measured in their newborns in the first 6 mo. of life. In both groups of mothers, the serum alkaline phosphatase rose significantly during the pregnancy (P < 0.001), followed by a significant fall after the births (epileptics: P < 0.05, controls: P < 0.001); the epileptic mothers had significantly higher initial serum alkaline phosphatase levels than the controls (P < 0.05). In both groups of newborns, a dramatic fall in serum Ca was observed in the 1st day of life (P < 0.001), followed by a normalization after 1 mo. The serum alkaline phosphatases doubled between day 8-30 in both groups (P < 0.001). In the standing debate whether epileptics should be treated prophylactically with vitamin D, the present study indicates that pregnancy in epileptics does not call for extra vitamin D supply and that their newborns do not develop more severe hypocalemia than controls.