title: Prospective surveillance of Croatian pregnant women on lamotrigine monotherapy--aspects of pre-pregnancy counseling and drug monitoring.
abstract: We prospectively surveyed 23 pregnant women with epilepsy on lamotrigine monotherapy and reported outcome of their pregnancies, including one fetal intrauterine death, one spontaneous abortion and two preterm deliveries. There were no congenital malformations in their offspring. Women with pregnancy planning and folic acid intake delivered babies with higher values of birth weight and birth length. There was large inter-patient variation during drug monitoring and in the need of dose adjustment. Individual approach to every woman and monotherapy with minimal effective lamotrigine dose with frequent drug monitoring enhances the possibility for successful pregnancy. The management of women with epilepsy should begin with pre-pregnancy counseling. Planned pregnancy enables periconceptional folic acid supplementation. Despite the small number of cases, these data indicate that la motrigine treatment during pregnancy might be relatively safe. Larger prospective studies are needed to obtain adequate power for statistical analysis including long-term cohort studies.
authors.affiliation: Center for Counseling in Epilepsy and Pregnancy, University Department of Neurology, Reference Center for Neurovascular Disorders, Ministry of Health and Social Welfare of Republic of Croatia, Zagreb. snjezana.miskov@zg.t-com.hr
authors.forename: Snjezana
authors.initials: S
authors.lastname: Miskov
authors.forename: Romana
authors.initials: R
authors.lastname: Gjergja-Juraski
authors.forename: Ljerka
authors.initials: L
authors.lastname: Cvitanović-Sojat
authors.forename: Tomislav Ivicević
authors.initials: TI
authors.lastname: Bakulić
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Fucić
authors.forename: Marija
authors.initials: M
authors.lastname: Bosnjak-Pasić
authors.forename: Ivan
authors.initials: I
authors.lastname: Mikula
authors.forename: Vida
authors.initials: V
authors.lastname: Demarin
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D016903:Drug Monitoring; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D016742:Preconception Care; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011256:Pregnancy Outcome; D014227:Triazines / Q000627:therapeutic use*
chemical_list: D000927:Anticonvulsants; D014227:Triazines; D000077213:Lamotrigine