Pregnancy outcome in women exposed to dopamine agonists during pregnancy: a pharmacoepidemiology study in EFEMERIS database

Hurault‐Delarue, Caroline; Montastruc, Jean‐Louis; Beau, A; Lacroix, Isabelle; Damase‐Michel, Christine

doi:10.1007/s00404-014-3210-z

Cited by 50 publications

(25 citation statements)

References 15 publications

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“…A case series that assessed the effect of the RLS medications; levodopa, pramipexole, ropinirole, and rotigotine on the fetus showed that there was no increased risk above baseline for major malformations or other adverse outcomes for levodopa and pramipexole (74). However, the use of bromocriptine, cabergoline, and quinagolide during the first trimester was associated with an increased risk of abortion and preterm birth (75). …”

Section: Dopaminergic Drugsmentioning

confidence: 99%

Restless legs syndrome and pregnancy: prevalence, possible pathophysiological mechanisms and treatment

et al. 2015

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Restless legs syndrome (RLS) is a common sleep disorder that may be associated with pregnancy. Studies have found that the prevalence of RLS among pregnant women ranged from 10 to 34%. Typically, there is complete remission of symptoms soon after parturition; however, in some patients, they may continue postpartum. RLS has been shown to be associated with a number of complications in pregnancy including preeclampsia and increased incidence of Cesarean sections. Although multiple hypotheses have been proposed to explain this association, each individual hypothesis cannot completely explain the whole pathogenesis. Present understanding suggests that a strong family history, low serum iron and ferritin level, and high estrogen level during pregnancy might play important roles. Vitamin D deficiency and calcium metabolism may also play a role. Medical treatment of RLS during pregnancy is difficult and challenging considering the risks to mother and fetus. However, in some cases, the disease may be severe enough to require treatment.

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Section: Dopaminergic Drugsmentioning

confidence: 99%

Restless legs syndrome and pregnancy: prevalence, possible pathophysiological mechanisms and treatment

et al. 2015

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“…Although serotonin is well established as a player in vertebrate embryonic development, the developmental functions of other neurotransmitter families are yet to be characterized. Information on involvement of neurotransmitters in pattern formation would not only identify novel components of embryogenesis, but also give important insight into potential new endpoints for teratogenic (embryotoxic) effects of widespread pharmaceuticals (Alwan et al 2007;Louik et al 2007;Colvin et al 2011;Myles et al 2013;Hurault-Delarue et al 2014;Yazdy et al 2014). To begin to identify possible patterning roles for other neurotransmitter families, this study took advantage of compounds developed for neuropharmacological research, and an exploratory drug screen was conducted in the Xenopus laevis embryo, a popular vertebrate model for the study of well-conserved developmental mechanisms (Kaltenbrun et al 2011;King et al 2012;Ori et al 2013;Pratt & Khakhalin, 2013;Schmitt et al 2014), as well as for studies of developmental toxicology (Sunderman et al 1991(Sunderman et al , 1992Fort et al 1992;Mouche et al 2011;Leconte & Mouche, 2013).…”

Section: Introductionmentioning

confidence: 99%

Neurotransmitter signaling pathways required for normal development inXenopus laevisembryos: a pharmacological survey screen

Sullivan

Levin

2016

Journal of Anatomy

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Neurotransmitters are not only involved in brain function but are also important signaling molecules for many diverse cell types. Neurotransmitters are widely conserved, from evolutionarily ancient organisms lacking nervous systems through man. Here, we report results from a loss- and gain-of-function survey, using pharmacologic modulators of several neurotransmitter pathways to examine possible roles in normal embryogenesis. Applying reagents targeting the glutamatergic, adrenergic, and dopaminergic pathways to embryos of Xenopus laevis from gastrulation to organogenesis stages, we observed and quantified numerous malformations including craniofacial defects, hyperpigmentation, muscle mispatterning, and miscoiling of the gut. These data implicate several key neurotransmitters in new embryonic patterning roles, reveal novel earlier stages for processes involved in eye development, suggest new targets for subsequent molecular-genetic investigation, and highlight the necessity for in-depth toxicology studies of psychoactive compounds to which human embryos might be exposed during pregnancy.

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“…Mandatory child medical certificates completed at 9 and 24 months include 14 items designed to detect children at risk of psychomotor development abnormalities [12,13]. Some of them are relevant to motor development, and others to psychological development.…”

Section: Discussionmentioning

confidence: 99%

“…[0], [1][2][3][4][5][6][7][8], [9][10][11][12][13][14][15][16][17] and [≥18], in order to analyze the doseresponse relationship between atropinic burden and each outcome. Women receiving no atropinic drug during pregnancy (score = 0) were used as the reference group for comparison.…”

Section: Discussionmentioning

confidence: 99%

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Atropinic burden of drugs during pregnancy and psychological development of children: a cohort study in the EFEMERIS database

Beau

Montastruc

Lacroix

et al. 2016

Brit J Clinical Pharma

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AIMThe aim of this study was to evaluate the potential effect of in utero exposure to drugs with atropinic properties on infant psychological development using atropinic burden (AB) scales. METHODSWomen from the EFEMERIS cohort, a French database including prescribed and dispensed reimbursed drugs during pregnancy and pregnancy outcomes, delivering between 2004 and 2010 were included (n = 43 740). Each drug was classified as having no (score = 0), few (score = 1) or strong (score = 3) atropinic properties. AB per woman was calculated by adding the atropinic scores of drugs prescribed during pregnancy. AB was categorized as exposure or no exposure. Secondary analyses were performed by dividing the exposure into four scores = [0], [1][2][3][4][5][6][7][8], [9][10][11][12][13][14][15][16][17] and [≥18]. Data for psychological development were extracted from children's medical certificates completed at 9 and 24 months. RESULTSThirty-four% (n = 14 925) of women received at least one atropinic drug during pregnancy. Women with AB ≥1 were older and received more drugs during pregnancy than unexposed women. At 24 months, more infants of mothers with AB ≥1 had difficulties to 'name a picture' (OR a , 1.18, 95% CI 1.03, 1.36) and to 'understand instructions' (OR a , 1.61, 95% CI 1.13, , 2.30]) compared with infants of unexposed women. Analyses of four groups of exposure and analyses excluding women receiving psychotropics led to similar results. CONCLUSIONSThe study showed significant association between in utero exposure to drugs with atropinic properties and fewer infant cognitive acquisitions at 24 months. Further exploring the potential effect of simultaneous use of drugs with atropinic effects among pregnant women will bring into consideration whether such prescriptions could be inappropriate for the child.British Journal of Clinical Pharmacology Br J Clin Pharmacol (2016) 82 478-486 478

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Pregnancy outcome in women exposed to dopamine agonists during pregnancy: a pharmacoepidemiology study in EFEMERIS database

Cited by 50 publications

References 15 publications

Restless legs syndrome and pregnancy: prevalence, possible pathophysiological mechanisms and treatment

Restless legs syndrome and pregnancy: prevalence, possible pathophysiological mechanisms and treatment

Neurotransmitter signaling pathways required for normal development inXenopus laevisembryos: a pharmacological survey screen

Atropinic burden of drugs during pregnancy and psychological development of children: a cohort study in the EFEMERIS database

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