Pregnancy, delivery, and neonatal complications after treatment with antiepileptic drugs

Pilo, Christina; Wide, Katarina; Winbladh, Birger

doi:10.1080/00016340600604625

Cited by 46 publications

(45 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…While in some other studies rate of caesarian section has been seen to be significantly higher as compared to normal population. [8][9][10] The most important concerns regarding use of AEDs during pregnancy is potential risk of gross congenital malformation in offspring. There are several possible mechanisms including genetic predisposition, direct effects of seizures, indirect effects of seizures like fall and injuries, poor antenatal care and teratogenic effects of AEDs.…”

Section: Resultsmentioning

confidence: 99%

Obstetric and neonatal outcome in women with epilepsy

Malik

Kumar

Chaudhary³

et al. 2017

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

Background: Epilepsy is the second most common neurological disorder complicating pregnancy next to migraine. Both mother and fetus stay at risk due to epilepsy and side effects of antiepileptic’s. This retrospective study was conducted to study fetal and maternal outcome in WWE.Methods: This study was conducted on 55 patients of epilepsy with pregnancy who attended antenatal clinic of our hospital from January 2016 to December 2016. Data was collected using antenatal registers in outdoor settings and medical case sheets in indoor patients and was analyzed statistically.Results: There were a total of 55 WWE in one year duration. Incidence of epilepsy being 0.4% in this study. 11 WWE were not on ante epileptic drug when conceived, while 34 WWE were on ante epileptic drugs when conceived, 8 WWE were newly diagnosed and 2 patients had both psychiatric disorders along with epilepsy. There were 3 IUDs, 4 major congenital malformation and 2 minor malformations. 2 major malformation occurred in patients taking both antipsychotic and ante epileptics since conception.Conclusions: There were a total of 55 WWE in one year duration. Incidence of epilepsy being 0.4% in this study. 11 WWE were not on ante epileptic drug when conceived, while 34 WWE were on ante epileptic drugs when conceived, 8 WWE were newly diagnosed and 2 patients had both psychiatric disorders along with epilepsy. There were 3 IUDs, 4 major congenital malformation and 2 minor malformations. 2 major malformation occurred in patients taking both antipsychotic and ante epileptics since conception.

show abstract

Section: Resultsmentioning

confidence: 99%

Obstetric and neonatal outcome in women with epilepsy

Malik

Kumar

Chaudhary³

et al. 2017

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

show abstract

“…110,111 A study based on Swedish Medical Birth registry data from 1995 to 2001 identified a higher proportion of caesarean section (odds ratio 1.64, 95% CI 1.43 to 1.88), pre-eclampsia (odds ratio 1.66, 95% CI 1.32 to 2.08) among women exposed to anticonvulsant mood stabilisers than among women not exposed. 71 Pilo et al 71 demonstrated a higher rate of children born with respiratory distress (odds ratio 2.06, 95% CI 1.62 to 2.63). Another Swedish study 112 also based on national health registries demonstrated that women with bipolar disorder treated with psychotropic medication (anticonvulsant mood stabilisers, lithium or antipsychotics) were more likely to experience caesarean section and preterm delivery.…”

Section: Anticonvulsant Mood Stabilisersmentioning

confidence: 99%

“…71 Initial research suggested a substantial increase in Ebstein's anomaly, a rare cardiovascular anomaly, following lithium exposure in pregnancy. 91 However, these findings may be caused by bias in reporting, as four subsequent case-control studies of Ebstein's anomalies did not identify any children born to women who took the drug during pregnancy.…”

Section: Lithiummentioning

confidence: 99%

“…14,15,19,48,[53][54][55]70,71 These included maternal outcomes such as pre-eclampsia, gestational diabetes, caesarean section, and perinatal death; child outcomes such as major congenital malformations and adverse birth outcomes such as low Apgar scores, preterm birth, low birthweight, tremor, agitation, any breathing problems; and problems with the infants' muscle tone, which we divide into 'poor birth outcomes' and 'transient poor birth outcomes'. We also conducted exploratory analyses to evaluate potential associations between psychotropic medication treatment in pregnancy and developmental and behavioural outcomes.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Risks and benefits of psychotropic medication in pregnancy: cohort studies based on UK electronic primary care health records

Petersen

McCrea

Sammon

et al. 2016

Health Technol Assess

133

View full text Add to dashboard Cite

BackgroundAlthough many women treated with psychotropic medication become pregnant, no psychotropic medication has been licensed for use in pregnancy. This leaves women and their health-care professionals in a treatment dilemma, as they need to balance the health of the woman with that of the unborn child. The aim of this project was to investigate the risks and benefits of psychotropic medication in women treated for psychosis who become pregnant.Objective(s)(1) To provide a descriptive account of psychotropic medication prescribed before pregnancy, during pregnancy and up to 15 months after delivery in UK primary care from 1995 to 2012; (2) to identify risk factors predictive of discontinuation and restarting of lithium (multiple manufacturers), anticonvulsant mood stabilisers and antipsychotic medication; (3) to examine the extent to which pregnancy is a determinant for discontinuation of psychotropic medication; (4) to examine prevalence of records suggestive of adverse mental health, deterioration or relapse 18 months before and during pregnancy, and up to 15 months after delivery; and (5) to estimate absolute and relative risks of adverse maternal and child outcomes of psychotropic treatment in pregnancy.DesignRetrospective cohort studies.SettingPrimary care.ParticipantsWomen treated for psychosis who became pregnant, and their children.InterventionsTreatment with antipsychotics, lithium or anticonvulsant mood stabilisers.Main outcome measuresDiscontinuation and restarting of treatment; worsening of mental health; acute pre-eclampsia/gestational hypertension; gestational diabetes; caesarean section; perinatal death; major congenital malformations; poor birth outcome (low birthweight, preterm birth, small for gestational age, low Apgar score); transient poor birth outcomes (tremor, agitation, breathing and muscle tone problems); and neurodevelopmental and behavioural disorders.Data sourcesClinical Practice Research Datalink database and The Health Improvement Network primary care database.ResultsPrescribing of psychotropic medication was relatively constant before pregnancy, decreased sharply in early pregnancy and peaked after delivery. Antipsychotic and anticonvulsant treatment increased over the study period. The recording of markers of worsening mental health peaked after delivery. Pregnancy was a strong determinant for discontinuation of psychotropic medication. However, between 40% and 76% of women who discontinued psychotropic medication before or in early pregnancy restarted treatment by 15 months after delivery. The risk of major congenital malformations, and neurodevelopmental and behavioural outcomes in valproate (multiple manufacturers) users was twice that in users of other anticonvulsants. The risks of adverse maternal and child outcomes in women who continued antipsychotic use in pregnancy were not greater than in those who discontinued treatment before pregnancy.LimitationsA few women would have received parts of their care outside primary care, which may not be captured in this analysis. Likewise, the analyses were based on prescribing data, which may differ from usage.ConclusionsPsychotropic medication is prescribed before, during and after pregnancy. Many women discontinue treatment before or during early pregnancy and then restart again in late pregnancy or after delivery. Our results support previous associations between valproate and adverse child outcomes but we found no evidence of such an association for antipsychotics.Future workFuture research should focus on (1) curtailing the use of sodium valproate; (2) estimating the benefits of psychotropic drug use in pregnancy; and (3) investigating the risks associated with lifestyle choices that are more prevalent among women using psychotropic drugs.Funding detailsThe National Institute for Health Research Health Technology Assessment programme.

show abstract

“…Популяционные исследования показывают, что в 15-30 % наблюдений имеется учащение при-ступов, другими исследованиями со схожим дизайном показано обратное [8][9][10].…”

unclassified

Pregnancy in epilepsy: management and delivery

et al. 2017

View full text Add to dashboard Cite

We evaluated 129 epileptic pregnant women between 2014 and 2016. Demographic features of the patients, along with type and duration of epileptic seizure, time of diagnosis, date of last seizure prior to pregnancy, number and duration of seizures during pregnancy, type of antiepileptic drugs, result and week of termination of pregnancy, and birth weight were registered, and also, we evaluated perinatal complications and fetal malformations.

show abstract

Pregnancy, delivery, and neonatal complications after treatment with antiepileptic drugs

Abstract: The study demonstrates a slightly increased risk only for preeclampsia, vaginal hemorrhage after delivery, and respiratory distress in the newborn after the use of AEDs during pregnancy.

Cited by 46 publications

References 10 publications

Obstetric and neonatal outcome in women with epilepsy

Obstetric and neonatal outcome in women with epilepsy

Risks and benefits of psychotropic medication in pregnancy: cohort studies based on UK electronic primary care health records

Pregnancy in epilepsy: management and delivery

Contact Info

Product

Resources

About