engleski

Surveillance of Croatian pregnant women with epilepsy and effects of antiepileptic drugs exposure in their offspring

Purpose: The aim was to follow up pregnancies exposed to AED and their offspring in order to assess teratogenic and neurodevelopmental effect of particular AED of newer generation. Methods: The study is prospective surveillance of pregnancies in Croatian women with epilepsy from May 2003 to May 2009. The data about pregnancy planning, folate supplementation, seizure frequency and AED therapy were obtained. The results were compared with healthy controls (mother/newborn pairs). Results: We have surveyed 68 pregnancies from 52 women: 91% (62/68) were exposed to monotherapy: 33 to lamotrigine (LTG): 19 live-births (LB), 2 premature deliveries (one with motor delay), 3 spontaneous abortions (SA), 1 artificial abortion, 1 intrauterine death and 7 ongoing pregnancies (OP). Eleven LB and 2 SA were exposed to carbamazepine (CBZ), 1 LB was under phenitoine (PHT) and 1 under phenobarbiton (PB) with EPH gestosis/peripartal asphyxia. One LB and 1 preterm LB with ASD, severe psychomotor delay and epilepsy was exposed to gabapentine (GBP), 5 LB and 1 OP were under valproic acid (VP). Two pregnancies were under meprobamate (MPB): 1 LB and 1 SA. Six pregnancies were exposed to polytherapy: 1 LB, 1 SA and 1 OP to topiramate (TPM) and VP, 1 still-birth to CBZ and PB, 1 LB with intrauterine growth retardation and dysmorphism to TPM, CBZ, PHT, and 1 OP to VP and clonazepam (CZP). Four pregnancies without AED resulted in healthy LB. About 35% of women have planned their pregnancy, but only 20% took folic acid periconceptionaly. Conclusion: We have surveyed pregnancies exposed to LTG, VP, PHT, PB, GBP, TMP, CBZ, MPB and CZP. AED polytherapy resulted in larger proportion of complications. Adequate preconceptional counseling in women with epilepsy resulted in higher proportion of pregnancy planning and folic acid intake. Further

pregnant; epilepsy; antiepileptic drugs

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