Comparative study of antiepileptic drug use during. Data on aed use and maternal characteristics were collected through phone interviews at enrollment, at 7 months gestation, and postpartum. Changes in drug disposition and their clinical implications, epilepsia. Comparative study of antiepileptic drug use during pregnancy over a. This study seeks to determine whether the effects of exposure to aeds during pregnancy depend on the childs genetic makeup. Antiepileptic drug use during pregnancy seizure european. The study population was pregnant women who enrolled in the north american aed pregnancy registry between 1997 and 2011. Mcm rates in pregnancies exposed to cbz, ltg, vpa, and pb were analyzed by dose at time of conception not throughout the first trimester or entire pregnancy. The north american aed pregnancy registry page 2 of 4.
Open access research comparative safety of antiepileptic. This information is key for comparative safety research, in which we compare patients on one drug with patients on another drug with similar indications and. Evidence for the comparative teratogenic risk of antiepileptic drugs is insufficient, particularly in relation to the dosage used. Comparative safety of antiepileptic drugs among infants and children exposed in utero or during breastfeeding. However, the treatment of epilepsy during pregnancy is a doubleedged sword, because many of the antiepileptic drugs aeds that most effectively control seizures are also teratogenic to various. Are newer antiepileptic drugs associated with improved safety. Most women with active epilepsy need treatment with antiepileptic drugs during pregnancy. Comparative safety of antiepileptic drugs for neurological development in children exposed during pregnancy and breast feeding.
Prenatal exposure to antiepileptic drugs and risk for. During pregnancy, the safety of women with epilepsy may be endangered by loss of seizure control caused by increased. Comparative safety of antiepileptic drugs among infants and. The north american aed antiepileptic drug pregnancy registry announces updated.
The european and international registry of antiepileptic drugs and pregnancy eurap confirmed that in addition to the type of aed, dose of the aed at conception also affects rates of mcm. Association between topiramate and zonisamide use during pregnancy and low birth weight. In this period, 353,171 pregnancies were identified in thin. Antiepileptic drugs aeds are used by pregnant women for various conditions, such as epilepsy, pain syndromes, psychiatric disorders and chronic migraine. Antiepileptic drugs aeds are used by pregnant women for various.
Institute of the alzheimers association and the national institute on aging working group. The prescription pattern of antiepileptic drugs aeds during pregnancy is changing but to what. Comparative safety of antiepileptic drugs during pregnancy ncbi. T he north american aed antiepileptic drug pregnancy registry announces updated results based on a 2012 study on the comparative safety of aed monotherapy during pregnancy.
However, there is a lack of sufficiently powered studies that assess the impact of aeds on neurodevelopment in children of women exposed to these agents. A discussion of the teratogenicity of antiepileptic drugs aeds may be found elsewhere. Are newer antiepileptic drugs associated with improved. Spectrum of neuraltube defects in 34 infants prenatally exposed to antiepileptic drugs. The clinical use of each drug will be considered, highlighting the practical problems likely to be encountered during every day clinical use.
Obstetrical and neonatal outcome following clonazepam use during pregnancy. These results continue to indicate that the prenatal. Women treated with aeds at the time of conception are enrolled early in. Thus, the risks introduced by the antiepileptic medications to the fetus as well as the effects of the seizures. Although the risk of prematurity, growth retardation, and major malformations is higher in infants of mothers using antiepileptic medications than in those of the mothers not using them, the harmful effects of the convulsive seizures on the maternal and fetal health are much more. Pdf comparative safety of antiepileptic drugs during pregnancy. Use of antiepileptic medications during pregnancy cdc. Efficacy of the newer antiepileptic drugs lamotrigine, levetiracetam, and oxcarbazepineestudio. Comparative risk of major congenital malformations with eight. Comparative study of antiepileptic drug use during pregnancy.
In addition to the safety issues that apply whenever antiepileptic drugs are taken by patients, additional safety related matters arise in pregnant women. Antiepileptic drugs in pregnancy and lactation australian. Comparative study of antiepileptic drug use during pregnancy over a period of 12 years in spain. Antiepileptic drugs and pregnancy outcomes wlodarczyk. May 22, 2012 comparative safety of antiepileptic drugs during pregnancy. Comparative study of antiepileptic drugs during pregnancy. Features of the fetal anticonvulsant syndrome include limb abnormalities, craniofacial abnormalities, and growth and development abnormalities. Antiepileptic drugs are also frequently used for other indications, such as migraine, pain syndromes, and psychiatric disorders, which are prevalent among women of childbearing age. How should antiepileptic drugs be selected during pregnancy. We encourage any pregnant woman who is taking an aed to call us at 18882332334 to enroll. Possible teratogenic effects of antiepileptic drugs are therefore of wide concern and the risks imposed by the drugs must be. Aed use during pregnancy and breastfeeding years poses severe risks to the fetus andor infant. Neurology 2012 may 22 risk for major congenital malformations is low for most aeds, although newer aeds are not necessarily safer than older ones. Pdf background pregnant women with epilepsy frequently experience seizures related to pregnancy complications and are often prescribed antiepileptic.
Hernandezdiaz s, smith cr, shen a, mittendorf r, hauser wa, yerby m, holmes lb. Epilepsy affects about 1% of the general population. Pdf comparative safety of antiepileptic drugs during. Comparative safety of antiepileptic drugs during pregnancy. Fetal abnormality women with epilepsy taking antiepileptic drugs have a greater 23 times risk than other women of having a baby with a fetal abnormality. Antiepileptic drugs in pregnancyquick decisions with long. Utilization of antiepileptic drugs during pregnancy. Women treated with aeds at the time of conception are enrolled early in pregnancy, and details on their treatment are recorded. However, less is known about the comparative safety of aed exposure in utero.
Carbamazepine, sodium valproate and lamotrigine were the most commonly used antiepileptic drugs in pregnancy between 1994 and 2012. Wed like to understand how you use our websites in order to improve them. Antiepileptic drugs aeds are used by pregnant women for various health conditions. We aimed to compare the risk of congenital malformations cms and prenatal outcomes of aeds in infantschildren who were exposed to aeds in. Comparative safety of antiepileptic drugs for neurological. Fetal growth and premature delivery in pregnant women on antiepileptic drugs. These may involve the women themselves or their foetuses, and apply both during, and for a time after, pregnancy.
To assess the safety of the newer antiepileptic drugs aeds during pregnancy. Risks of major congenital malformation associated with lamotrigine, levetiracetam, and oxcarbazepine were within the range reported in the literature for offspring unexposed to antiepileptic drugs. The study population was pregnant women who enrolled in. Teratogenic effects of antiepileptic drugs the lancet neurology. Jul 30, 2012 as with all medications during pregnancy, clinicians must assess the risks and benefits of these medications and fully discuss the topic with their patients. Different antiepileptic drugs and dosages have different teratogenic risks. Update on monotherapy findings aed pregnancy registry. Eurap is an international pregnancy registry that aims primarily at assessing the teratogenic potential of individual antiepileptic drugs aeds and their combinations eurap study group, 2006. These drugs are not without their hazards and their optimum use must be governed by an appreciation of their potential for doserelated and idiosyncratic toxicity table 4. Hernandezdiaz s1, smith cr, shen a, mittendorf r, hauser wa, yerby m, holmes lb.
Comparative safety of antiepileptic drugs during pregnancy s. However, previous studies consistently have found that babies born to women who take certain antiepileptic medications during pregnancy have an increased risk for birth defects. Antiepileptic drugs in pregnancy and duration of pregnancy. The management of epilepsy in women during pregnancy poses a special. Pregnant women need treatment for epilepsy because it is possible that seizures can cause adverse health outcomes for the mother and her developing baby. Crossref torbjorn tomson, cecilie johannessen landmark and dina battino, antiepileptic drug treatment in pregnancy. In fact, the rate of malformation is comparable between the untreated group. These findings facilitate rational selection of these drugs, taking into account comparative risks associated with. Pregnant women with epilepsy frequently experience seizures related to pregnancy complications and are often prescribed antiepileptic drugs aeds to manage their symptoms. Any adverse effect that the antiepileptic drug could have on the developing child needs to be avoided or minimised during pregnancy and lactation. Results one in 200 women were prescribed antiepileptic drugs in pregnancy.