Document Detail


Antiepileptic drug use during pregnancy: perinatal outcomes.
MedLine Citation:
PMID:  21763158     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: This study was undertaken to (1) measure the frequency of AED monotherapy or polytherapy during pregnancy and AED discontinuation prior to pregnancy in a cohort of women with treated epilepsy; and (2) describe the frequency of major congenital malformations according to maternal use of AED during pregnancy.
METHODS: A cohort of epileptic pregnant women was identified within the Quebec Pregnancy Registry and was divided into three groups based on maternal AED use during pregnancy: AED monotherapy, AED polytherapy and no AED use.
RESULTS: Of the 349 pregnancies meeting eligibility criteria, 79.6% were exposed to AED monotherapy and 5.8% to polytherapy during pregnancy; 14.6% discontinued AED prior to pregnancy. The most commonly used AEDs were carbamazepine (29.9%) and valproic acid (19.7%); the most common AED polytherapy combination was carbamazepine combined with clobazam (2.5%). Of 111 deliveries in the group of women on monotherapy during pregnancy, 9.9% (n=11) were born with major congenital malformations; in the group of women treated with polytherapy, 19.0% (n=8 over 42) of babies had major congenital malformations compared to 20.0% in women who discontinued AEDs prior to pregnancy.
CONCLUSION: This study demonstrates that the majority of women suffering from epilepsy were treated with monotherapy rather than polytherapy during pregnancy. While most used other agents, an important number of women continued to use valproate in pregnancy despite the long standing evidence of its teratogenicity and increasing evidence of its neuro-toxicity to the fetus.
Authors:
Sophie Kulaga; Odile Sheehy; Amir H Zargarzadeh; Krystel Moussally; Anick Bérard
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-07-16
Journal Detail:
Title:  Seizure     Volume:  20     ISSN:  1532-2688     ISO Abbreviation:  Seizure     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-10-03     Completed Date:  2012-07-30     Revised Date:  2014-10-21    
Medline Journal Info:
Nlm Unique ID:  9306979     Medline TA:  Seizure     Country:  England    
Other Details:
Languages:  eng     Pagination:  667-72     Citation Subset:  IM    
Copyright Information:
Copyright © 2011. Published by Elsevier Ltd.
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MeSH Terms
Descriptor/Qualifier:
Abnormalities, Drug-Induced / diagnosis,  epidemiology
Adolescent
Adult
Anticonvulsants / administration & dosage,  adverse effects*
Carbamazepine / administration & dosage,  adverse effects
Cohort Studies
Drug Therapy, Combination
Epilepsy / drug therapy*,  epidemiology
Female
Humans
Infant, Newborn
Middle Aged
Pregnancy
Pregnancy Outcome / epidemiology*
Prenatal Exposure Delayed Effects / chemically induced*,  diagnosis,  epidemiology*
Quebec / epidemiology
Registries
Valproic Acid / administration & dosage,  adverse effects
Young Adult
Grant Support
ID/Acronym/Agency:
//Canadian Institutes of Health Research
Chemical
Reg. No./Substance:
0/Anticonvulsants; 33CM23913M/Carbamazepine; 614OI1Z5WI/Valproic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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