Neurodevelopment Following Exposure to Antiseizure Medications in Utero: A Review

Bromley, Rebecca; Bluett-Duncan, Matthew

doi:10.2174/1570159x19666210716111814

Cited by 15 publications

(14 citation statements)

References 85 publications

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“…The review by Bromley and Bluet-Duncan [ 8 ] summarizes the data related to long-term neurodevelopment of children exposed in utero to various antiepileptic drugs (AEDs). Of the AEDs valproic acid seems to be definitely associated with a significant increase in neurodevelopmental problems among the offspring, including language impairment, reduced cognitive abilities and increased rate of ASD.…”

Section: Editorialmentioning

confidence: 99%

Neurotropic Drugs in Pregnancy and Lactation from the Point of View of the Clinical Teratologist

Ornoy

Koren

2021

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Section: Editorialmentioning

confidence: 99%

Neurotropic Drugs in Pregnancy and Lactation from the Point of View of the Clinical Teratologist

Ornoy

Koren

2021

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“… 15 16 Current data about the reproductive safety of antipsychotics and benzodiazepines are limited, 17–19 while the short-term and long-term risk posed by the antiseizure drug valproate is now well acknowledged. 20 21 …”

Section: Introductionmentioning

confidence: 99%

Perceived risk of neurodevelopmental outcomes in offspring related to psychotropic and mental illness exposures in pregnancy and breastfeeding: a cross-sectional survey of women with past or current mental illness

et al. 2022

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ObjectivesTo investigate the perceived risk of psychotropic and mental illness exposures (1) during pregnancy or (2) while breastfeeding on offspring neurodevelopment, and factors associated with this perception in women with past/current mental illness.DesignCross-sectional, web-based study.SettingNationwide in Norway, June 2020–June 2021.ParticipantsWomen aged 18–55 years who were pregnant, recent mothers or planning a pregnancy, and had been offered antidepressants in the last 5 years.Primary and secondary outcome measuresPerceived risk of prenatal and breastmilk exposure to psychotropic medications and maternal mental illness on offspring neurodevelopmental outcomes.ResultsWe included 448 women: 234 pregnant, 146 mothers and 68 planning a pregnancy. On a 0–10 scale, women perceived antidepressants as least harmful both (1) in pregnancy (mean score 4.2, 95% CI 3.6 to 4.8) and (2) while breastfeeding (mean score 3.8, 95% CI 3.3 to 4.4), relative to antipsychotics, anxiety/sleeping medication or antiepileptics (mean score range: 6.3–6.5 during pregnancy, 5.5–6.2 while breastfeeding). Many participants were unfamiliar with psychotropics other than antidepressants. The perceived risk of mental illness exposure exceeded that of antidepressants (mean score range 5.6–5.9) in both exposure periods. Using general linear models, factors associated with greater antidepressant risk perception in both exposure periods included having lower education, non-Norwegian native language, and employment status (range mean score difference (β): 2.07–6.07). For pregnant women and mothers, there was an inverse association between perceived risk and the perceived antidepressant effectiveness in both exposure periods (range of β: −0.18 to –0.25).ConclusionsIn women with past/current mental illness, the perceived risk of antidepressant exposure on child neurodevelopment was lower than that for maternal mental illness. Other psychotropic medications were perceived as more harmful. As medication risk perception influences the decision-making regarding treatment of mental illness, pre- and pregnancy counselling should target women with characteristics associated with higher perceived risk.

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“…Prenatal exposure to certain ASMs such as valproate, phenobarbital, phenytoin, carbamazepine, and topiramate is associated with an increased risk of congenital malformations 3 . Exposure to valproate and possibly phenobarbital has been associated with increased risk of impaired neurocognitive and behavioral development 4 …”

Section: Introductionmentioning

confidence: 99%

“…3 Exposure to valproate and possibly phenobarbital has been associated with increased risk of impaired neurocognitive and behavioral development. 4 Thus, women with ASM-treated epilepsy may have more concerns during pregnancy than women without epilepsy. Appropriate management and counseling before conception, during pregnancy, and in the postpartum period are essential for optimal outcomes.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of self‐reported emotional, physical, and sexual abuse and association with fear of childbirth in pregnant women with epilepsy: The Norwegian Mother, Father, and Child Cohort Study

et al. 2022

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Objective: This study was undertaken to examine the prevalence of self-reported experiences with abuse in pregnant women with epilepsy and the association between having experienced abuse and childbirth expectations, particularly the fear of childbirth. Methods:We performed a cross-sectional study of women with and without epilepsy enrolled in the Norwegian Mother, Father, and Child Cohort Study 1999-2008. Data on epilepsy diagnosis; antiseizure medication (ASM) use; emotional, physical, and sexual abuse; and childbirth expectations were collected from questionnaires completed during gestational Weeks 17-19 and 30. Results: Our study population included 295 women with ASM-treated epilepsy, 318 women with ASM-untreated epilepsy, and 93 949 women without epilepsy.A total of 115 women (47%) with ASM-treated and 132 women (57%) with ASMuntreated epilepsy reported any emotional, physical, or sexual abuse, compared to 25 100 women (32%) without epilepsy. The adjusted odds ratios (aORs) for having experienced any abuse were 1.8 (95% confidence interval [CI] = 1.4-2.3) and 1.8 (95% CI = 1.4-2.2) for ASM-treated and ASM-untreated epilepsy, respectively. A total of 29 women (11%) with ASM-treated and 34 women (11%) with ASM-untreated epilepsy reported having been raped, compared to 3088 women (4%) without epilepsy (aORs = 2.8 [95% CI = 1.8-4.1] and 2.9 [95% CI = 2.0-4.2], respectively). In nulliparous women with ASM-untreated epilepsy, having experienced abuse was associated with fear of childbirth; 22 women (31%) with abuse experiences reported fear of childbirth compared to five women (7%) with no experience of abuse ). This association was not seen in multiparous women or in women with ASM-treated epilepsy.

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Neurodevelopment Following Exposure to Antiseizure Medications in Utero: A Review

Cited by 15 publications

References 85 publications

Neurotropic Drugs in Pregnancy and Lactation from the Point of View of the Clinical Teratologist

Neurotropic Drugs in Pregnancy and Lactation from the Point of View of the Clinical Teratologist

Perceived risk of neurodevelopmental outcomes in offspring related to psychotropic and mental illness exposures in pregnancy and breastfeeding: a cross-sectional survey of women with past or current mental illness

Prevalence of self‐reported emotional, physical, and sexual abuse and association with fear of childbirth in pregnant women with epilepsy: The Norwegian Mother, Father, and Child Cohort Study

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