Differential effects of antiepileptic drugs on neonatal outcomes.
2012 Aug
Journal Article
Authors:
Pennell, P.B.;
Klein, A.M.;
Browning, N.;
Baker, G.A.;
Clayton-Smith, J.;
Kalayjian, L.A.;
Liporace, J.D.;
Privitera, M.;
Crawford, T.;
Loring, D.W.;
Meador, K.J.
Secondary:
Epilepsy Behav
Volume:
24
Pagination:
449-56
Issue:
4
PMID:
22749607
DOI:
10.1016/j.yebeh.2012.05.010
Keywords:
Adult; Anticonvulsants; Apgar Score; Birth Weight; Child, Preschool; Cognition Disorders; Epilepsy; Female; Head; Humans; Infant; Male; Microcephaly; Pregnancy; Premature Birth; Prenatal Exposure Delayed Effects; Regression Analysis; Retrospective Studies
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.
