Management issues for women with epilepsy - Focus on pregnancy (an evidence-based review)

II. Teratogenesis and perinatal outcomes: Report of the Quality Standards Subcommittee and Therapeutics and Technology Subcommittee of the American Academy of Neurology and the American Epilepsy Society

Cynthia L. Harden, Kimford J. Meador, Page B. Pennell, W. Allen Hauser, Gary S. Gronseth, Jacqueline A. French, Samuel Wiebe, David Thurman, Barbara S. Koppel, Peter W Kaplan, Julian N. Robinson, Jennifer Hopp, Tricia Y. Ting, Barry Gidal, Collin A. Hovinga, Andrew N. Wilner, Blanca Vazquez, Lewis Holmes, Allan Krumholz, Richard Finnell & 2 others Deborah Hirtz, Claire Le Guen

Research output: Contribution to journalArticle

Abstract

A committee assembled by the American Academy of Neurology (AAN) reassessed the evidence related to the care of women with epilepsy (WWE) during pregnancy, including antiepileptic drug (AED) teratogenicity and adverse perinatal outcomes. It is highly probable that intrauterine first-trimester valproate (VPA) exposure has higher risk of major congenital malformations (MCMs) compared to carbamazepine (CBZ), and possibly compared to phenytoin (PHT) or lamotrigine (LTG). It is probable that VPA as part of polytherapy and possible that VPA as monotherapy contribute to the development of MCMs. AED polytherapy probably contributes to the development of MCMs and reduced cognitive outcomes compared to monotherapy. Intrauterine exposure to VPA monotherapy probably reduces cognitive outcomes and monotherapy exposure to PHT or phenobarbital (PB) possibly reduces cognitive outcomes. Neonates of WWE taking AEDs probably have an increased risk of being small for gestational age and possibly have an increased risk of a 1-minute Apgar score of

Original languageEnglish (US)
Pages (from-to)1237-1246
Number of pages10
JournalEpilepsia
Volume50
Issue number5
DOIs
StatePublished - May 2009

Fingerprint

Teratogenesis
Valproic Acid
Epilepsy
Technology
Pregnancy
Phenytoin
Anticonvulsants
Apgar Score
Carbamazepine
First Pregnancy Trimester
Therapeutics
Phenobarbital
Combination Drug Therapy
Gestational Age
Newborn Infant

Keywords

  • Antiepileptic drugs
  • Apgar score
  • Epilepsy
  • Guideline
  • Major congenital malformations
  • Pregnancy
  • Small for gestational age
  • Teratogenesis

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Management issues for women with epilepsy - Focus on pregnancy (an evidence-based review) : II. Teratogenesis and perinatal outcomes: Report of the Quality Standards Subcommittee and Therapeutics and Technology Subcommittee of the American Academy of Neurology and the American Epilepsy Society. / Harden, Cynthia L.; Meador, Kimford J.; Pennell, Page B.; Allen Hauser, W.; Gronseth, Gary S.; French, Jacqueline A.; Wiebe, Samuel; Thurman, David; Koppel, Barbara S.; Kaplan, Peter W; Robinson, Julian N.; Hopp, Jennifer; Ting, Tricia Y.; Gidal, Barry; Hovinga, Collin A.; Wilner, Andrew N.; Vazquez, Blanca; Holmes, Lewis; Krumholz, Allan; Finnell, Richard; Hirtz, Deborah; Le Guen, Claire.

In: Epilepsia, Vol. 50, No. 5, 05.2009, p. 1237-1246.

Research output: Contribution to journalArticle

Harden, CL, Meador, KJ, Pennell, PB, Allen Hauser, W, Gronseth, GS, French, JA, Wiebe, S, Thurman, D, Koppel, BS, Kaplan, PW, Robinson, JN, Hopp, J, Ting, TY, Gidal, B, Hovinga, CA, Wilner, AN, Vazquez, B, Holmes, L, Krumholz, A, Finnell, R, Hirtz, D & Le Guen, C 2009, 'Management issues for women with epilepsy - Focus on pregnancy (an evidence-based review): II. Teratogenesis and perinatal outcomes: Report of the Quality Standards Subcommittee and Therapeutics and Technology Subcommittee of the American Academy of Neurology and the American Epilepsy Society', Epilepsia, vol. 50, no. 5, pp. 1237-1246. https://doi.org/10.1111/j.1528-1167.2009.02129.x
Harden, Cynthia L. ; Meador, Kimford J. ; Pennell, Page B. ; Allen Hauser, W. ; Gronseth, Gary S. ; French, Jacqueline A. ; Wiebe, Samuel ; Thurman, David ; Koppel, Barbara S. ; Kaplan, Peter W ; Robinson, Julian N. ; Hopp, Jennifer ; Ting, Tricia Y. ; Gidal, Barry ; Hovinga, Collin A. ; Wilner, Andrew N. ; Vazquez, Blanca ; Holmes, Lewis ; Krumholz, Allan ; Finnell, Richard ; Hirtz, Deborah ; Le Guen, Claire. / Management issues for women with epilepsy - Focus on pregnancy (an evidence-based review) : II. Teratogenesis and perinatal outcomes: Report of the Quality Standards Subcommittee and Therapeutics and Technology Subcommittee of the American Academy of Neurology and the American Epilepsy Society. In: Epilepsia. 2009 ; Vol. 50, No. 5. pp. 1237-1246.
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