title: Differential effects of antiepileptic drugs on neonatal outcomes.
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.
authors: Harvard Medical School, Brigham and Women's Hospital, 75 Francis Street, Brigham and Women's Hospital, Boston, MA 02115, USA. ppennell@partners.org
authors: P B
authors: PB
authors: Pennell
authors: A M
authors: AM
authors: Klein
authors: N
authors: N
authors: Browning
authors: G A
authors: GA
authors: Baker
authors: J
authors: J
authors: Clayton-Smith
authors: L A
authors: LA
authors: Kalayjian
authors: J D
authors: JD
authors: Liporace
authors: M
authors: M
authors: Privitera
authors: T
authors: T
authors: Crawford
authors: D W
authors: DW
authors: Loring
authors: K J
authors: KJ
authors: Meador
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects*; D001034:Apgar Score; D001724:Birth Weight / Q000187:drug effects; D002675:Child, Preschool; D003072:Cognition Disorders / Q000209:etiology*; D004827:Epilepsy / Q000188:drug therapy; D005260:Female; D006257:Head / Q000473:pathology; D006801:Humans; D007223:Infant; D008297:Male; D008831:Microcephaly / Q000139:chemically induced; D011247:Pregnancy; D047928:Premature Birth / Q000139:chemically induced; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced* / Q000503:physiopathology*; D012044:Regression Analysis; D012189:Retrospective Studies
chemical_list: D000927:Anticonvulsants