Journal ArticleDOI
Increased rate of major malformations in offspring exposed to valproate during pregnancy
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TLDR
Maternal exposure to valproic acid during the first trimester of pregnancy significantly increased the risk of major malformations in infants whose mothers had taken the drug VPA as monotherapy and had enrolled in the North American Antiepileptic Drug Pregnancy Registry.Abstract:
Objective: To determine the rate of occurrence of major malformations in infants whose mothers had taken the drug valproic acid (VPA) as monotherapy during the first trimester of pregnancy and had enrolled in the North American Antiepileptic Drug Pregnancy Registry. Methods: Data were collected from pregnant women throughout the United States and Canada through telephone-based interviews. Each woman was interviewed at enrollment, at 7 months’ gestation, and postpartum. With her written permission, the medical records of each mother and her infant were obtained. The major malformations tabulated were those identified at or before 5 days of age. The prevalence of congenital malformations among offspring of monotherapy VPA-exposed women was compared with that among infants of women exposed to all other antiepileptic drugs (internal comparison group) and with that among newborns in the Active Malformations Surveillance Program at Brigham and Women’s Hospital (external comparison group). Results: Sixteen affected cases were identified among 149 VPA-exposed women (proportion: 10.7%; 95% CI: 6.3 to 16.9%). The prevalence in the internal comparison group was 2.9% (95% CI: 2.0 to 4.1%; odds ratio: 4.0, 95% CI: 2.1 to 7.4; p p Conclusion: Maternal exposure to valproic acid during the first trimester of pregnancy significantly increased the risk of major malformations.read more
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Journal ArticleDOI
Malformation risks of antiepileptic drugs in pregnancy: a prospective study from the UK Epilepsy and Pregnancy Register
Ji Morrow,Aline Russell,Eleanor Guthrie,L. Parsons,I. Robertson,R. Waddell,B. Irwin,R.C. McGivern,Patrick J. Morrison,John Craig +9 more
TL;DR: Only 4.2% of live births to women with epilepsy had an MCM, and polytherapy exposure was greater than for monotherapy exposure, and carbamazepine was associated with the lowest risk of MCM.
Journal ArticleDOI
Cognitive Function at 3 Years of Age after Fetal Exposure to Antiepileptic Drugs
Kimford J. Meador,Gus A. Baker,Nancy Browning,Jill Clayton-Smith,Deborah T. Combs-Cantrell,Morris J. Cohen,Laura A. Kalayjian,Andres M. Kanner,Joyce Liporace,Page B. Pennell,Michael Privitera,David W. Loring +11 more
TL;DR: In utero exposure to valproate, as compared with other commonly used antiepileptic drugs, is associated with an increased risk of impaired cognitive function at 3 years of age, and this finding supports a recommendation thatValproate not be used as a first-choice drug in women of childbearing potential.
Journal ArticleDOI
Dose-dependent risk of malformations with antiepileptic drugs: an analysis of data from the EURAP epilepsy and pregnancy registry.
Torbjörn Tomson,Dina Battino,Erminio Bonizzoni,John Craig,Dick Lindhout,Anne Sabers,Emilio Perucca,Frank J.E. Vajda +7 more
TL;DR: The risk of major congenital malformations is influenced not only by type of antiepileptic drug, but also by dose and other variables, which should be taken into account in the management of epilepsy in women of childbearing potential.
Dose-dependent risk of malformations with antiepileptic drugs: an analysis of data from the EURAP epilepsy and pregnancy registry
TL;DR: The risk posed to unborn children by powerful epilepsy drugs could be easier to avoid following an 11-year study as discussed by the authors, while the four most common drugs are all linked with a higher chance of birth defects.
Journal ArticleDOI
Valproic Acid Monotherapy in Pregnancy and Major Congenital Malformations
Janneke Jentink,Maria Loane,Helen Dolk,Ingeborg Barišić,Ester Garne,Joan K. Morris,Lolkje T. W. de Jong-van den Berg +6 more
TL;DR: The use of valproic acid monotherapy in the first trimester of pregnancy was associated with significantly increased risks of several congenital malformations, as compared with no use of antiepileptic drugs or with use of other antiespecific drugs.
References
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Journal ArticleDOI
Folic acid antagonists during pregnancy and the risk of birth defects.
TL;DR: The relative risks of cardiovascular defects and oral clefts in infants whose mothers were exposed to dihydrofolate reductase inhibitors during the second trimester of pregnancy are revealed.
Journal ArticleDOI
The teratogenicity of anticonvulsant drugs.
Lewis B. Holmes,Elizabeth A. Harvey,Brent A. Coull,Kelly B. Huntington,Shahram Khoshbin,Ailish M. Hayes,Louise Ryan +6 more
TL;DR: A distinctive pattern of physical abnormalities in infants of mothers with epilepsy is associated with the use of anticonvulsant drugs during pregnancy, rather than with epilepsy itself.
Journal ArticleDOI
Maternal valproic acid and congenital neural tube defects
Elisabeth Robert,Pierre Guibaud +1 more
Journal ArticleDOI
The longer term outcome of children born to mothers with epilepsy
N Adab,Usha Kini,J. Vinten,Jon G Ayres,Gus A. Baker,Jill Clayton-Smith,Helen Coyle,Alan Fryer,Joanne Gorry,J. Gregg,George E. Mawer,Paola Nicolaides,L Pickering,L Tunnicliffe,David Chadwick +14 more
TL;DR: This study identifies valproate as a drug carrying potential risks for developmental delay and cognitive impairment and is the first to suggest that frequent tonic-clonic seizures in pregnancy have a similar effect.
Journal ArticleDOI
A clinical study of 57 children with fetal anticonvulsant syndromes
Susan J Moore,Peter D. Turnpenny,A. Quinn,S. Glover,David J. Lloyd,Tara Montgomery,John Dean +6 more
TL;DR: Speech delay, joint laxity, glue ear, and myopia are common in the fetal anticonvulsant syndromes and autistic features and hyperactivity form part of the behavioural phenotype.
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