Neonatal Outcomes in the MONEAD Study of Pregnant Women with Epilepsy
Objective: To determine whether growth measures at birth differ between offspring of pregnant women with epilepsy and healthy pregnant women. Study design: The Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD) study is a National Institutes of Health–funded, prospectiv...
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2021-01-01
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| Series: | The Journal of Pediatrics: X |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590042021000100 |
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| author | Linda J. Van Marter, MD, MPH Page B. Pennell, MD Carrie Brown, MS Adam L. Hartman, MD Ryan C. May, PhD Thomas McElrath, MD, PhD Dominic Ippolito, MS Kimford J. Meador, MD Anto Bagic, MD Gregory Barkley, MD Jennifer Cavitt, MD Jennifer DeWolfe, MD Jacqueline French, MD Evan Gedzelman, MD Elizabeth Gerard, MD Sean Hwang, MD Laura Kalayjian, MD Gregory Krauss, MD David Labiner, MD Paul McCabe, MD John Miller, MD Alison Pack, MD Patricia Penovich, MD Maria Sam, MD Enrique Serrano, MD Suzanne Strickland, MD |
| author_facet | Linda J. Van Marter, MD, MPH Page B. Pennell, MD Carrie Brown, MS Adam L. Hartman, MD Ryan C. May, PhD Thomas McElrath, MD, PhD Dominic Ippolito, MS Kimford J. Meador, MD Anto Bagic, MD Gregory Barkley, MD Jennifer Cavitt, MD Jennifer DeWolfe, MD Jacqueline French, MD Evan Gedzelman, MD Elizabeth Gerard, MD Sean Hwang, MD Laura Kalayjian, MD Gregory Krauss, MD David Labiner, MD Paul McCabe, MD John Miller, MD Alison Pack, MD Patricia Penovich, MD Maria Sam, MD Enrique Serrano, MD Suzanne Strickland, MD |
| author_sort | Linda J. Van Marter, MD, MPH |
| collection | DOAJ |
| description | Objective: To determine whether growth measures at birth differ between offspring of pregnant women with epilepsy and healthy pregnant women. Study design: The Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD) study is a National Institutes of Health–funded, prospective, observational, multicenter investigation of pregnancy outcomes for mothers and their infants. Between 2012 and 2016, pregnant women with epilepsy and healthy pregnant women were enrolled at 20 US epilepsy centers. Pregnant women with epilepsy were exposed to various antiepileptic drugs. The main outcome measure was small for gestational age at birth. Principal univariate and multivariate analyses compared outcomes between pregnant women with epilepsy and healthy pregnant women. Secondary analyses focused on outcomes among mothers receiving different antiepileptic drug therapies. Results: In total, 345 infants were born to 331 pregnant women with epilepsy and 106 infants were born to 102 healthy pregnant women. No differences were seen between infants born to pregnant women with epilepsy vs healthy pregnant women in preterm births, major congenital malformations, 5-minute Apgar <6, special care nursery or neonatal intensive care unit admission, gestational age, or any growth measure. There was no difference in the rates of small for gestational age status among infants born to pregnant women with epilepsy vs healthy pregnant women; however, infants born to mothers receiving topiramate had lower birth weight z scores and lamotrigine higher birth weight z scores compared with other monotherapies. The greatest rate of special care nursery or neonatal intensive care unit admission was observed among those on oxcarbazepine monotherapy. Conclusions: Maternal treatment with antiepileptic drugs, overall, appears unassociated with adverse early neonatal outcomes. However, specific monotherapies appear to affect fetal growth with, on average, the greatest reduction in birth weight z score observed among infants born to pregnant women with epilepsy exposed to topiramate monotherapy. Trial registration: ClinicalTrials.govNCT01730170 |
| first_indexed | 2024-12-20T01:20:29Z |
| format | Article |
| id | doaj.art-1101e24856784e01be678b29caf7b47c |
| institution | Directory Open Access Journal |
| issn | 2590-0420 |
| language | English |
| last_indexed | 2024-12-20T01:20:29Z |
| publishDate | 2021-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Journal of Pediatrics: X |
| spelling | doaj.art-1101e24856784e01be678b29caf7b47c2022-12-21T19:58:27ZengElsevierThe Journal of Pediatrics: X2590-04202021-01-017100073Neonatal Outcomes in the MONEAD Study of Pregnant Women with EpilepsyLinda J. Van Marter, MD, MPH0Page B. Pennell, MD1Carrie Brown, MS2Adam L. Hartman, MD3Ryan C. May, PhD4Thomas McElrath, MD, PhD5Dominic Ippolito, MS6Kimford J. Meador, MD7Anto Bagic, MDGregory Barkley, MDJennifer Cavitt, MDJennifer DeWolfe, MDJacqueline French, MDEvan Gedzelman, MDElizabeth Gerard, MDSean Hwang, MDLaura Kalayjian, MDGregory Krauss, MDDavid Labiner, MDPaul McCabe, MDJohn Miller, MDAlison Pack, MDPatricia Penovich, MDMaria Sam, MDEnrique Serrano, MDSuzanne Strickland, MDBrigham & Women's Hospital, Harvard Medical School, Boston, MA; Reprint requests: Dr Linda J. Van Marter, MD, MPH, Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, CWN 418, Boston, MA 02118Brigham & Women's Hospital, Harvard Medical School, Boston, MAEmmes Corporation, Rockville, MDNational Institute of Neurological Disorders & Stroke, Bethesda, MDEmmes Corporation, Rockville, MDBrigham & Women's Hospital, Harvard Medical School, Boston, MAEmmes Corporation, Rockville, MDStanford University, Stanford, CAObjective: To determine whether growth measures at birth differ between offspring of pregnant women with epilepsy and healthy pregnant women. Study design: The Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD) study is a National Institutes of Health–funded, prospective, observational, multicenter investigation of pregnancy outcomes for mothers and their infants. Between 2012 and 2016, pregnant women with epilepsy and healthy pregnant women were enrolled at 20 US epilepsy centers. Pregnant women with epilepsy were exposed to various antiepileptic drugs. The main outcome measure was small for gestational age at birth. Principal univariate and multivariate analyses compared outcomes between pregnant women with epilepsy and healthy pregnant women. Secondary analyses focused on outcomes among mothers receiving different antiepileptic drug therapies. Results: In total, 345 infants were born to 331 pregnant women with epilepsy and 106 infants were born to 102 healthy pregnant women. No differences were seen between infants born to pregnant women with epilepsy vs healthy pregnant women in preterm births, major congenital malformations, 5-minute Apgar <6, special care nursery or neonatal intensive care unit admission, gestational age, or any growth measure. There was no difference in the rates of small for gestational age status among infants born to pregnant women with epilepsy vs healthy pregnant women; however, infants born to mothers receiving topiramate had lower birth weight z scores and lamotrigine higher birth weight z scores compared with other monotherapies. The greatest rate of special care nursery or neonatal intensive care unit admission was observed among those on oxcarbazepine monotherapy. Conclusions: Maternal treatment with antiepileptic drugs, overall, appears unassociated with adverse early neonatal outcomes. However, specific monotherapies appear to affect fetal growth with, on average, the greatest reduction in birth weight z score observed among infants born to pregnant women with epilepsy exposed to topiramate monotherapy. Trial registration: ClinicalTrials.govNCT01730170http://www.sciencedirect.com/science/article/pii/S2590042021000100epilepsypregnancyanticonvulsantsnewbornneonateoutcomes |
| spellingShingle | Linda J. Van Marter, MD, MPH Page B. Pennell, MD Carrie Brown, MS Adam L. Hartman, MD Ryan C. May, PhD Thomas McElrath, MD, PhD Dominic Ippolito, MS Kimford J. Meador, MD Anto Bagic, MD Gregory Barkley, MD Jennifer Cavitt, MD Jennifer DeWolfe, MD Jacqueline French, MD Evan Gedzelman, MD Elizabeth Gerard, MD Sean Hwang, MD Laura Kalayjian, MD Gregory Krauss, MD David Labiner, MD Paul McCabe, MD John Miller, MD Alison Pack, MD Patricia Penovich, MD Maria Sam, MD Enrique Serrano, MD Suzanne Strickland, MD Neonatal Outcomes in the MONEAD Study of Pregnant Women with Epilepsy The Journal of Pediatrics: X epilepsy pregnancy anticonvulsants newborn neonate outcomes |
| title | Neonatal Outcomes in the MONEAD Study of Pregnant Women with Epilepsy |
| title_full | Neonatal Outcomes in the MONEAD Study of Pregnant Women with Epilepsy |
| title_fullStr | Neonatal Outcomes in the MONEAD Study of Pregnant Women with Epilepsy |
| title_full_unstemmed | Neonatal Outcomes in the MONEAD Study of Pregnant Women with Epilepsy |
| title_short | Neonatal Outcomes in the MONEAD Study of Pregnant Women with Epilepsy |
| title_sort | neonatal outcomes in the monead study of pregnant women with epilepsy |
| topic | epilepsy pregnancy anticonvulsants newborn neonate outcomes |
| url | http://www.sciencedirect.com/science/article/pii/S2590042021000100 |
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