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Antiepileptic drug treatment during pregnancy and neonatal screening results
K Wide1, B Winbladh, C Guthenberg
1Department of Paediatrics, Karolinska Institute, Karolinska Hospital, Stockholm, Sweden.
Insights
Neonatal screening for thyroid and adrenal hormones showed no significant differences in infants exposed to antiepileptic drugs in utero. This suggests these drugs may not impact key neonatal metabolic pathways.
Area of Science:
- Pharmacology and Toxicology
- Neonatal Medicine
- Endocrinology
Background:
- Antiepileptic drugs (AEDs) are known to induce hepatic enzymes, affecting steroid and thyroid hormone metabolism.
- AEDs readily cross the placenta, and the developing fetal liver is metabolically active.
Purpose of the Study:
- To evaluate the impact of in utero exposure to antiepileptic drugs on neonatal screening results for thyroid-stimulating hormone (TSH) and 17-hydroxyprogesterone.
Main Methods:
- Neonatal screening blood samples were analyzed for TSH and 17-hydroxyprogesterone levels.
- Study included 34 infants exposed to AEDs and matched controls.
Main Results:
- No statistically significant differences were observed in TSH or 17-hydroxyprogesterone levels between the study group and controls.
- This indicates no detectable impact on these specific neonatal endocrine screening markers.
Conclusions:
- In utero exposure to antiepileptic drugs did not appear to significantly alter neonatal screening results for TSH and 17-hydroxyprogesterone in this cohort.
- Further research may be warranted to explore potential long-term effects or impacts on other hormonal pathways.
Abstract:
Many antiepileptic drugs induce hepatic metabolic enzymes and thus enhance metabolism of steroid and thyroid hormones. Antiepileptic drugs readily cross the placenta and the foetal liver is metabolically active. We therefore evaluated the neonatal screening results of TSH and 17-hydroxyprogesterone in 34 study children and their matched controls. There were no statistically significant differences in the results between the groups.