Birth outcomes in pregnant women with epilepsy: A Nationwide multicenter study from Türkiye-Reference-Cited by-同舟云学术

Birth outcomes in pregnant women with epilepsy: A Nationwide multicenter study from Türkiye

Published:2023-07-14 Issue:9 Volume:64 Page:2310-2321
ISSN:0013-9580
Container-title:Epilepsia
language:en
Short-container-title:Epilepsia

Author:

Pekoz Mehmet Taylan¹^ORCID,Aslan‐Kara Kezban¹^ORCID,Tekin Betül²^ORCID,Gurses Candan³^ORCID,Yeni Seher Naz⁴^ORCID,Bozdemir Hacer¹^ORCID,Keskin‐Guler Selda⁵^ORCID,Ataklı Dilek²^ORCID,Gul Gunay²^ORCID,Eren Fulya²^ORCID,Sarı Hüseyin²^ORCID,Gul Zeynep Baştug²^ORCID,Ceyhan‐Dirican Ayten²^ORCID,Genc Fatma⁶^ORCID,Bicer‐Gomceli Yasemin⁷^ORCID,Ozkara Cigdem⁴^ORCID,Delil Sakir⁴^ORCID,Atalar Arife Cimen⁸^ORCID,Bebek Nerses⁸^ORCID,Baykan Betül⁸^ORCID,Bora İbrahim⁹^ORCID,Bican‐Demir Aylin⁹^ORCID,Mısırlı Cemile Handan¹⁰^ORCID,Tutkavul Kemal¹⁰^ORCID,Velioglu Sibel K.¹¹^ORCID,Ilhan‐Algin Demet¹²^ORCID,Erdinc Oguz¹²^ORCID,Saygi Serap¹³^ORCID,Tezer‐Fılık Irsel¹³^ORCID,Apaydın‐Dogan Ebru¹⁴^ORCID,Akyol Ali¹⁵^ORCID,Kamisli Ozden¹⁶^ORCID,Yalcın A. Destina¹⁷^ORCID,Cakmak Gonul¹⁸^ORCID,Ersoy Alevtina¹⁹^ORCID,Ustun‐Ozek Sibel²⁰^ORCID,Halac Gulistan²¹^ORCID,Kutlu Gulnihal²²^ORCID,Tantik‐Pak Aygul²³^ORCID,Yücel Sevinc P.²⁴^ORCID

Affiliation:

1. Department of Neurology Çukurova University School of Medicine Adana Türkiye

2. Department of Neurology University of Health Sciences, Bakırkoy Prof. Dr. Mazhar Osman Mental Health and Neurological Diseases Hospital Istanbul Türkiye

3. Department of Neurology Koç University School of Medicine İstanbul Türkiye

4. Department of Neurology Istanbul University–Cerrahpasa School of Medicine Istanbul Türkiye

5. Department of Neurology University of Health Sciences, Ankara Training and Research Hospital Ankara Türkiye

6. Department of Neurology University of Health Sciences, Antalya Training and Research Hospital Antalya Türkiye

7. Department of Neurology Antalya Training and Research Hospital Antalya Türkiye

8. Department of Neurology Istanbul University School of Medicine Istanbul Türkiye

9. Department of Neurology Uludag University School of Medicine Bursa Türkiye

10. Department of Neurology University of Health Sciences, Haydarpasa Numune Training and Research Hospital Istanbul Türkiye

11. Department of Neurology Karadeniz Technical University School of Medicine Trabzon Türkiye

12. Department of Neurology Osmangazi University School of Medicine Eskisehir Türkiye

13. Department of Neurology Hacettepe University School of Medicine Ankara Türkiye

14. Department of Neurology Akdeniz University School of Medicine Antalya Türkiye

15. Department of Neurology Adnan Menderes University School of Medicine Aydın Türkiye

16. Department of Neurology İnönü University Turgut Özal Medical Center Training and Research Hospital Malatya Türkiye

17. Department of Neurology University of Health Sciences, Umraniye Training and Research Hospital Istanbul Türkiye

18. Department of Neurology Sanko University Faculty of Medicine Gazıantep Türkiye

19. Department of Neurology Erzincan Binali Yildirim University School of Medicine Erzincan Türkiye

20. Department of Neurology University of Health Sciences, Prof. Dr. Cemil Taşçıoğlu City Hospital Istanbul Türkiye

21. Department of Neurology University of Health Sciences, Bezm‐i Alem Valide Sultan Vakif Gureba Training and Research Hospital Istanbul Türkiye

22. Department of Neurology Mugla Sıtkı Kocman University School of Medicine Muğla Türkiye

23. Department of Neurology University of Health Sciences, Gaziosmanpasa Training and Research Hospital Istanbul Türkiye

24. Department of Biostatistics Çukurova University School of Medicine Adana Türkiye

Abstract

AbstractObjectiveThe present study was aimed at investigating the effects of anti‐seizure medications (ASMs), patient demographic characteristics, and the seizure type and frequency on the development of congenital malformations (CMs) in the infants of pregnant women with epilepsy (PWWE).MethodsPWWE followed up at the neurology outpatient clinic of 21 centers between 2014 and 2019 were included in this prospective study. The follow‐up of PWWE was conducted using structured, general pregnant follow‐up forms prepared by the Pregnancy and Epilepsy Study Committee. The newborns were examined by a neonatologist after delivery and at 1 and 3 months postpartum.ResultsOf the infants of 759 PWWE, 7.2% had CMs, with 5.6% having major CMs. Polytherapy, monotherapy, and no medications were received by 168 (22.1%), 548 (72.2 %), and 43 (5.7 %) patients, respectively. CMs were detected at an incidence of 2.3% in infants of PWWE who did not receive medication, 5.7% in infants of PWWE who received monotherapy, and 13.7% in infants of PWWE who received polytherapy. The risk of malformation was 2.31‐fold (95% confidence interval (CI): 1.48–4.61, p < .001) higher in infants of PWWE who received polytherapy. Levetiracetam was the most frequently used seizure medication as monotherapy, with the highest incidence of CMs occurring with valproic acid (VPA) use (8.5%) and the lowest with lamotrigine use (2.1%). The incidence of CMs was 5% at a carbamazepine dose <700 mg, 10% at a carbamazepine dose ≥700 mg, 5.5% at a VPA dose <750 mg, and 14.8% at a VPA dose ≥750 mg. Thus the risk of malformation increased 2.33 times (p = .041) in infants of PWWE receiving high‐dose ASMs.SignificanceBirth outcomes of PWWE receiving and not receiving ASMs were evaluated. The risk of CMs occurrence was higher, particularly in infants of PWWE using VPA and receiving polytherapy. The incidence of CMs was found to be lower in infants of PWWE receiving lamotrigine.

Publisher

Wiley

Subject

Neurology (clinical),Neurology

Link

https://onlinelibrary.wiley.com/doi/pdf/10.1111/epi.17692

Reference41 articles.

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