Prenatal exposure to phenytoin and its effect on postnatal growth and craniofacial proportion in the rat

Neonatal rats exposed prenatally to phenytoin (PHT) have been reported to have craniofacial abnormalities and growth retardation [Lorente et al.: Teratology 24:169-180, 1981]. This study reports on the persistence of these effects in the adult rat. Pregnant Sprague-Dawley rats were intubated on gestational days 9, 11, and 13 with 1,000 mg/kg PHT suspended in 1% carboxymethylcellulose (CMC). Six male and six female exposed offspring (PHT) and an equal number of control animals (CMC) were weighed through postnatal day 135, at which point they were killed and the skeletons were prepared for analysis. The PHT-exposed animals had reduced weights at all time points with the males more severely affected. A normal adolescent growth spurt was not observed in the exposed group. Absent or rudimentary lacrimal bones and nasolacrimal canals were note in all PHT-exposed rats. This contributed to the recessed positioning of the eyes that was grossly apparent. In addition, shorter and broader frontal bones in the PHT animals led to the appearance of hypertelorism. Ratios of craniofacial dimensions obtained by direct measurement of the skulls showed that the PHT offspring were significantly different in proportion from their control counterparts. The PHT skulls were smaller for body size with reduced facial height and broader midfacial regions. A unique craniofacial pattern was observed in the experimental offspring. Normal sexual dimorphism in craniofacial pattern was not expressed in the PHT group. These studies suggest that prenatal phenytoin exposure in the rat may interfere with the full expression of normal dimorphism based on gender and confirms the toxic effect of this drug on postnatal growth, adult body proportion, and craniofacial geometry.