The Teratogenicity of Anticonvulsant Drugs

Holmes, Lewis B.; Harvey, Elizabeth A.; Coull, Brent A.; Huntington, Kelly B.; Khoshbin, Shahram; Hayes, Ailish M.; Ryan, Louise

doi:10.1097/00006254-200109000-00006

Cited by 157 publications

(242 citation statements)

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“…Our developing expertise and related publications helped us to obtain National Institutes of Health funding to study all newborns at five Boston area hospitals whose mothers had used an anticonvulsant drug for any reason during pregnancy. 10 One significant finding was that the infants of mothers who had a history of epilepsy but had used no anticonvulsant drugs in pregnancy were not different from the infants in the unexposed comparison group. Subsequent studies have shown that the severity of the mother's epilepsy was not a confounding factor in the infant's phenotype.…”

Section: Successmentioning

confidence: 98%

“…These clinical studies showed that details matter: definitions, measurements, masked examiners, and an unexposed comparison group were essential to an informative study design. 10 During this period at BLI, we realized that fetal exposure to anticonvulsant drugs and maternal diabetes were the two potential teratogens that we would be able to study with adequate statistical power. The Surveillance Program was suspended in 1975 because the office space was no longer available.…”

Section: Progressmentioning

confidence: 99%

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Hearts and hands as the starting point

Holmes

2015

Genetics in Medicine

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Section: Successmentioning

confidence: 98%

Section: Progressmentioning

confidence: 99%

Hearts and hands as the starting point

Holmes

2015

Genetics in Medicine

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“…It is widely accepted that prenatal exposure to antiepileptic drugs (AEDs) increases the risk of major congenital malformations (MCM) in the fetus [1]. AED-related abnormalities include congenital midline heart defects, neural tube defects, cleft lip and palate, polydactyly, and urogenital abnormalities (hypospadia, duplex system, renal dysplasia, hydronephrosis) [2].…”

Section: Introductionmentioning

confidence: 99%

Unilateral multicystic dysplastic kidney in infants exposed to antiepileptic drugs during pregnancy

et al. 2007

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Prenatal exposure to antiepileptic drugs (AEDs) increases the risk of major congenital malformations (MCM) in the fetus. AED-related abnormalities include heart and neural tube defects, cleft palate, and urogenital abnormalities. Among the various congenital anomalies of the kidney and urinary tract (CAKUT), multicystic dysplastic kidney (MCDK) disease is one of the most severe expressions. Although prenatal ultrasound (US) examination has increased the prenatal diagnosis of MCDK, the pathogenesis is still unclear. We report on four cases of MCDK in infants of epileptic women treated with AEDs during pregnancy. From October 2003 to June 2006, we observed four infants with unilateral MCDK born to epileptic women. Three patients were considered to have typical features of multicystic dysplastic kidney, and one infant was operated because of a cystic pelvic mass in the absence of a kidney in the left flank. The macroscopic appearance of this mass showed an ectopic multicystic kidney confirmed by histological findings. All patients have been studied by US scans, voiding cystourethrogram (VCUG), and radionuclide screening isotope imaging. The prenatal exposure to AEDs increases the risk of major congenital malformations from the background risk of 1-2% to 4-9%. AEDs may determine a defect in apoptosis regulation that could lead to abnormal nephrogenesis, causing MCDK. Carbamazepine (CBZ) and phenobarbital (PHB) during pregnancy should be used at the lowest dosage compatible with maternal disease. The reduction, or even suspension, of drug dosage should be achieved from the periconceptional period to the first 8 weeks of gestation to avoid any interference with organogenesis

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“…54 These major malformations can be seen in around 25% of children exposed to AED in utero. 55 The three most common AEDs used for BPD are valproate (VPA), carbamazepine (CBZ), and lamotrigine.…”

mentioning

confidence: 99%

“…54,56 Neural tube defects, which are typically lumbosacral in nature, are among its most devastating effects, and the risk of NTDs can reach 1%-2%. 55,56 Other malformations reported are facial clefting, hypospadias, and skeletal abnormalities. 57 Additionally, VPA has been clearly shown to have effects on the cognitive, verbal, behavioral, and neurodevelopmental abilities, 56,58 and the FDA released a drug-safety announcement regarding these findings in 2011.…”

mentioning

confidence: 99%

Psychotropic Medications in Pregnancy and the Postpartum Period

Haas

McHugh

Durst

et al. 2015

Clinical Medicine Insights: Therapeutics

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Many pregnant women suffer from mental health conditions while pregnant. As providers and patients make decisions about risks of the conditions and treatments during pregnancy, information to populate those discussions is needed. Taking into account the physiologic changes in pregnancy, we may need to optimize medication therapy. This article reviews and summarizes some of the most common mental health conditions suffered in pregnancy: depression, bipolar disorder, anxiety, and psychosis. It further discusses the different medications used to treat them, as well as risks associated with these medications.

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The Teratogenicity of Anticonvulsant Drugs

Cited by 157 publications

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Hearts and hands as the starting point

Hearts and hands as the starting point

Unilateral multicystic dysplastic kidney in infants exposed to antiepileptic drugs during pregnancy

Psychotropic Medications in Pregnancy and the Postpartum Period

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