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Electrophoretic Delivery of γ-aminobutyric Acid (GABA) into Epileptic Focus Prevents Seizures in Mice
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Antiepileptic treatment in pregnant women: morphological and behavioural effects

Torbjörn Tomson1, Dina Battino

  • 1Department of Clinical Neuroscience, Karolinska Institutet, S-171 76 Stockholm, Sweden. torbjorn.tomson@karolinska.se

Handbook of Experimental Pharmacology
|September 2, 2011
PubMed

Insights

Antiepileptic drug (AED) exposure in utero increases risks for birth defects and cognitive issues. Valproate shows higher risks than carbamazepine or lamotrigine, with newer AED data still limited.

Area of Science:

  • Obstetrics and Gynecology
  • Pediatric Neurology
  • Pharmacology

Background:

  • Antiepileptic drugs (AEDs) are crucial for managing epilepsy during pregnancy.
  • However, in utero exposure to AEDs is linked to adverse pregnancy outcomes.
  • Uncontrolled seizures also pose significant risks to both mother and fetus.

Purpose of the Study:

  • To review the risks of antiepileptic drugs (AEDs) during pregnancy.
  • To compare malformation and cognitive outcomes associated with different AEDs.
  • To highlight data gaps for newer generation AEDs.

Main Methods:

  • Review of existing literature on AEDs and pregnancy outcomes.
  • Analysis of reported rates of major congenital malformations.
  • Comparison of cognitive development data following in utero AED exposure.

Main Results:

  • AED exposure in utero is associated with increased risks of fetal growth retardation, major congenital malformations, and cognitive impairment.
  • Malformation rates range from 4-10%, significantly higher than the general population.
  • Valproate exposure is linked to higher malformation rates and potentially poorer cognitive outcomes compared to carbamazepine and lamotrigine.

Conclusions:

  • AED treatment is often necessary during pregnancy despite risks.
  • Valproate appears to carry higher risks than carbamazepine and lamotrigine.
  • More research is needed on newer AEDs regarding pregnancy outcomes.

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