Abstract
OBJECTIVE: To reassess the evidence for management issues related to the care of women with epilepsy (WWE) during pregnancy. METHODS: Systematic review of relevant articles published between January 1985 and June 2007. RESULTS: It is highly probable that intrauterine first-trimester valproate (VPA) exposure has higher risk of major congenital malformations (MCMs) compared to carbamazepine and possible compared to phenytoin or lamotrigine. Compared to untreated WWE, it is probable that VPA as part of polytherapy and possible that VPA as monotherapy contribute to the development of MCMs. It is probable that antiepileptic drug (AED) polytherapy as compared to monotherapy regimens contributes to the development of MCMs and to reduced cognitive outcomes. For monotherapy, intrauterine exposure to VPA probably reduces cognitive outcomes. Further, monotherapy exposure to phenytoin or phenobarbital 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 language | English (US) |
|---|---|
| Pages (from-to) | 133-141 |
| Number of pages | 9 |
| Journal | Neurology |
| Volume | 73 |
| Issue number | 2 |
| DOIs | |
| State | Published - Jul 2009 |
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ASJC Scopus subject areas
- Clinical Neurology
Cite this
Practice parameter update : Management issues for women with epilepsy - Focus on pregnancy (an evidence-based review): Teratogenesis and perinatal outcomes: Report of the Quality Standards Subcommittee and Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and American Epilepsy Society. / Harden, C. L.; Meador, K. J.; Pennell, P. B.; Hauser, W. A.; Gronseth, G. S.; French, J. A.; Wiebe, S.; Thurman, D.; Koppel, B. S.; Kaplan, Peter W; Robinson, J. N.; Hopp, J.; Ting, T. Y.; Gidal, B.; Hovinga, C. A.; Wilner, A. N.; Vazquez, B.; Holmes, L.; Krumholz, A.; Finnell, R.; Hirtz, D.; Le Guen, C.
In: Neurology, Vol. 73, No. 2, 07.2009, p. 133-141.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Practice parameter update
T2 - Management issues for women with epilepsy - Focus on pregnancy (an evidence-based review): Teratogenesis and perinatal outcomes: Report of the Quality Standards Subcommittee and Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and American Epilepsy Society
AU - Harden, C. L.
AU - Meador, K. J.
AU - Pennell, P. B.
AU - Hauser, W. A.
AU - Gronseth, G. S.
AU - French, J. A.
AU - Wiebe, S.
AU - Thurman, D.
AU - Koppel, B. S.
AU - Kaplan, Peter W
AU - Robinson, J. N.
AU - Hopp, J.
AU - Ting, T. Y.
AU - Gidal, B.
AU - Hovinga, C. A.
AU - Wilner, A. N.
AU - Vazquez, B.
AU - Holmes, L.
AU - Krumholz, A.
AU - Finnell, R.
AU - Hirtz, D.
AU - Le Guen, C.
PY - 2009/7
Y1 - 2009/7
N2 - OBJECTIVE: To reassess the evidence for management issues related to the care of women with epilepsy (WWE) during pregnancy. METHODS: Systematic review of relevant articles published between January 1985 and June 2007. RESULTS: It is highly probable that intrauterine first-trimester valproate (VPA) exposure has higher risk of major congenital malformations (MCMs) compared to carbamazepine and possible compared to phenytoin or lamotrigine. Compared to untreated WWE, it is probable that VPA as part of polytherapy and possible that VPA as monotherapy contribute to the development of MCMs. It is probable that antiepileptic drug (AED) polytherapy as compared to monotherapy regimens contributes to the development of MCMs and to reduced cognitive outcomes. For monotherapy, intrauterine exposure to VPA probably reduces cognitive outcomes. Further, monotherapy exposure to phenytoin or phenobarbital 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
AB - OBJECTIVE: To reassess the evidence for management issues related to the care of women with epilepsy (WWE) during pregnancy. METHODS: Systematic review of relevant articles published between January 1985 and June 2007. RESULTS: It is highly probable that intrauterine first-trimester valproate (VPA) exposure has higher risk of major congenital malformations (MCMs) compared to carbamazepine and possible compared to phenytoin or lamotrigine. Compared to untreated WWE, it is probable that VPA as part of polytherapy and possible that VPA as monotherapy contribute to the development of MCMs. It is probable that antiepileptic drug (AED) polytherapy as compared to monotherapy regimens contributes to the development of MCMs and to reduced cognitive outcomes. For monotherapy, intrauterine exposure to VPA probably reduces cognitive outcomes. Further, monotherapy exposure to phenytoin or phenobarbital 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
UR - http://www.scopus.com/inward/record.url?scp=68149143987&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=68149143987&partnerID=8YFLogxK
U2 - 10.1212/WNL.0b013e3181a6b312
DO - 10.1212/WNL.0b013e3181a6b312
M3 - Article
VL - 73
SP - 133
EP - 141
JO - Neurology
JF - Neurology
SN - 0028-3878
IS - 2
ER -