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. 2012 Aug;24(4):449-56.
doi: 10.1016/j.yebeh.2012.05.010. Epub 2012 Jun 29.

Differential effects of antiepileptic drugs on neonatal outcomes

P B Pennell  1 , A M Klein, N Browning, G A Baker, J Clayton-Smith, L A Kalayjian, J D Liporace, M Privitera, T Crawford, D W Loring, K J Meador; NEAD Study Group
Affiliations

Differential effects of antiepileptic drugs on neonatal outcomes

P B Pennell et al. Epilepsy Behav. 2012 Aug.

Abstract

Offspring of women with epilepsy (WWE) on AEDs are at increased risks for major congenital malformations and reduced cognition. They may be at risk for other adverse neonatal outcomes. Women with epilepsy on carbamazepine (CBZ), lamotrigine (LTG), phenytoin (PHT), or valproate (VPA) monotherapy were enrolled in a prospective, observational, multicenter study of the neurodevelopmental effects of AEDs. The odds ratio for small for gestational age (SGA) was higher for VPA vs. PHT, VPA vs. LTG, and CBZ vs. PHT. Microcephaly rates were elevated to 12% for all newborns and at 12 months old, but normalized by age 24 months. Reduced Apgar scores occurred more frequently in the VPA and PHT groups at 1 min, but scores were near normal in all groups at 5 min. This study demonstrates increased risks for being born SGA in the VPA and CBZ groups, and transiently reduced Apgar scores in the VPA and PHT groups. Differential risks among the AEDs can help inform decisions about AED selection for women during childbearing years.

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Figures

Figure 1
Figure 1
Percent of newborns in each AED group that met criteria for Small for Gestational Age (<10th percentile). (CBZ = carbamazepine, LTG = lamotrigine, PHT = phenytoin, VPA = valproate).
See this image and copyright information in PMC

References

    1. [Accessed October 22, 2011];Epilepsy. 2010 Available from: http://www.who.int/mediacentre/factsheets/fs999/en/index.html.
    1. Harden CL, Meador KJ, Pennell PB, Hauser WA, Gronseth GS, French JA, et al. Practice parameter update: management issues for women with epilepsy--focus on pregnancy (an evidence-based review): teratogenesis and perinatal outcomes: report of the Quality Standards Subcommittee and Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and American Epilepsy Society. Neurology. 2009;73(2):133–141. - PMC - PubMed
    1. Meador KJ, Baker GA, Browning N, Clayton-Smith J, Combs-Cantrell DT, Cohen M, et al. Cognitive function at 3 years of age after fetal exposure to antiepileptic drugs. N Engl J Med. 2009 Apr 16;360(16):1597–605. - PMC - PubMed
    1. [Accessed October 22, 2011];FDA Drug Safety Communication: Children born to mothers who took Valproate products while pregnant may have impaired cognitive development (6/30/2011) http://www.fda.gov/Drugs/DrugSafety/ucm261543.htm.
    1. Lundgren EM, Tuvemo T. Effects of being born small for gestational age on long-term intellectual performance. Best Pract Res Clin Endocrinol Metab. 2008;22(3):477–488. - PubMed

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