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Review
. 2022 Nov;40(4):755-768.
doi: 10.1016/j.ncl.2022.03.006. Epub 2022 Sep 28.

Effects of Maternal Use of Antiseizure Medications on Child Development

Kimford J Meador  1
Affiliations
Review

Effects of Maternal Use of Antiseizure Medications on Child Development

Kimford J Meador. Neurol Clin. 2022 Nov.

Abstract

Most children born to women with epilepsy (WWE) are normal, but have increased risks for malformations and poor neuropsychological outcomes. Antiseizure medications (ASMs) are among the most commonly prescribed teratogenic medications in women of childbearing age. However, WWE typically cannot avoid using ASMs during pregnancy. Teratogenic risks vary across ASMs. Valproate poses a special risk for anatomic and behavioral teratogenic risks compared with other ASMs. The risks for many ASMs remain uncertain. Women of childbearing potential taking ASMs should be taking folic acid. Breastfeeding while taking ASMs seems safe. WWE should receive informed consent outlining risks before conception.

Keywords: Anticonvulsants; Epilepsy; Malformations; Neurodevelopmental outcomes; Pregnancy.

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Conflict of interest statement

Disclosure K.J. Meador has received research support from the National Institutes of Health, Eisai, and Medtronic Inc. The Epilepsy Study Consortium pays his university for his research consultant time related to Eisai, GW Pharmaceuticals, NeuroPace, Novartis, Supernus, Upsher-Smith Laboratories, UCB Pharma, and Vivus Pharmaceuticals. In addition, K.J. Meador is Co-I and Director of Cognitive Core of the Human Epilepsy Project for the Epilepsy Study Consortium. K.J. Meador is on the editorial boards for Neurology, Cognitive & Behavioral Neurology, Epilepsy & Behavior, and Epilepsy & Behavior Case Reports.

Figures

Figure 1.
Figure 1.. Malformation rates (mean %, 95% CIs) as function of ASM (adapted from references #13-17).
LEV=levetiracetam, LTG=lamotrigine, OXC=oxcarbazepine, CBZ=carbamazepine, TPM=topiramate, PHT=phenytoin, PB=phenobarbital, VPA=valproate
Figure 2.
Figure 2.. Malformation rates (mean %, 95% CIs) as function of ASM dose (adapted from reference #14).
CBZ=carbamazepine, LTG=lamotrigine, PB=phenobarbital, VPA=valproate. Dosages given as mg/day.
See this image and copyright information in PMC

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