Management of epilepsy in pregnancy: What we still need to learn
Safe pregnancies have been a major concern for women with epilepsy. With more than 50 years of research, we have learned that antiseizure medications (ASMs) differ in their teratogenic risk. Valproate is associated with greater risks for malformations and adverse neurodevelopmental outcomes than oth...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | Epilepsy & Behavior Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589986423000424 |
| _version_ | 1797400858658340864 |
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| author | Torbjörn Tomson Leihao Sha Lei Chen |
| author_facet | Torbjörn Tomson Leihao Sha Lei Chen |
| author_sort | Torbjörn Tomson |
| collection | DOAJ |
| description | Safe pregnancies have been a major concern for women with epilepsy. With more than 50 years of research, we have learned that antiseizure medications (ASMs) differ in their teratogenic risk. Valproate is associated with greater risks for malformations and adverse neurodevelopmental outcomes than other ASMs. Furthermore, seizure control is important for maternal health in pregnancy and it can be affected by a decline in serum concentrations of many ASMs during pregnancy.However, significant knowledge gaps remain. First, there is insufficient evidence about the relative teratogenic risks of most newer generation ASMs, as well as diverse ASM combinations. Similarly, information on gestation-induced changes in maternal serum levels and transfer into breastmilk is inadequate for the majority of the newer ASMs. Further, the optimal dose of folate supplementation remains unknown for women with epilepsy. Finally, most of previous studies on epilepsy and pregnancy come from Europe or North America. Efforts should be made to include more countries in collaboration with existing prospective epilepsy and pregnancy studies to increase the cohort size while at the same time enhancing the generalizability of the results. Large countries, such as China, present great potential to shorten the time to obtain answers to important unsolved questions. |
| first_indexed | 2024-03-09T02:01:40Z |
| format | Article |
| id | doaj.art-49c4f1db3d0e43bfbfb8c45d35a91d13 |
| institution | Directory Open Access Journal |
| issn | 2589-9864 |
| language | English |
| last_indexed | 2024-03-09T02:01:40Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Epilepsy & Behavior Reports |
| spelling | doaj.art-49c4f1db3d0e43bfbfb8c45d35a91d132023-12-08T04:45:51ZengElsevierEpilepsy & Behavior Reports2589-98642023-01-0124100624Management of epilepsy in pregnancy: What we still need to learnTorbjörn Tomson0Leihao Sha1Lei Chen2Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SwedenDepartment of Neurology, Joint Research Institution of Altitude Health, West China Hospital, Sichuan University, Chengdu 610041, SichuanDepartment of Neurology, Joint Research Institution of Altitude Health, West China Hospital, Sichuan University, Chengdu 610041, Sichuan; Corresponding author.Safe pregnancies have been a major concern for women with epilepsy. With more than 50 years of research, we have learned that antiseizure medications (ASMs) differ in their teratogenic risk. Valproate is associated with greater risks for malformations and adverse neurodevelopmental outcomes than other ASMs. Furthermore, seizure control is important for maternal health in pregnancy and it can be affected by a decline in serum concentrations of many ASMs during pregnancy.However, significant knowledge gaps remain. First, there is insufficient evidence about the relative teratogenic risks of most newer generation ASMs, as well as diverse ASM combinations. Similarly, information on gestation-induced changes in maternal serum levels and transfer into breastmilk is inadequate for the majority of the newer ASMs. Further, the optimal dose of folate supplementation remains unknown for women with epilepsy. Finally, most of previous studies on epilepsy and pregnancy come from Europe or North America. Efforts should be made to include more countries in collaboration with existing prospective epilepsy and pregnancy studies to increase the cohort size while at the same time enhancing the generalizability of the results. Large countries, such as China, present great potential to shorten the time to obtain answers to important unsolved questions.http://www.sciencedirect.com/science/article/pii/S2589986423000424Women with epilepsySafe pregnancyAntiseizure medicationTeratogenic risk |
| spellingShingle | Torbjörn Tomson Leihao Sha Lei Chen Management of epilepsy in pregnancy: What we still need to learn Epilepsy & Behavior Reports Women with epilepsy Safe pregnancy Antiseizure medication Teratogenic risk |
| title | Management of epilepsy in pregnancy: What we still need to learn |
| title_full | Management of epilepsy in pregnancy: What we still need to learn |
| title_fullStr | Management of epilepsy in pregnancy: What we still need to learn |
| title_full_unstemmed | Management of epilepsy in pregnancy: What we still need to learn |
| title_short | Management of epilepsy in pregnancy: What we still need to learn |
| title_sort | management of epilepsy in pregnancy what we still need to learn |
| topic | Women with epilepsy Safe pregnancy Antiseizure medication Teratogenic risk |
| url | http://www.sciencedirect.com/science/article/pii/S2589986423000424 |
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