Abstract Details

Title Pregnancy Outcomes with Newer Antiepileptic Agents

Topic Epilepsy

Presentation(s) IN8 - (-)

Poster/Presentation
Number 004

Objective

Background Numerous reports confirm toxicity of AEDs on the fetus. Effects include fetal demise, major congenital malformations, and developmental delay. Less is known about the safety of newer AEDs during pregnancy.

Design/Methods Questionnaires were sent to women with epilepsy (WWE) in our practice who were pregnant between 2006 and the present. Informed consent was signed. Questions asked included folate use, pregnancy complications and developmental outcome. For this study, new AEDs were defined as approved after 1990.

Results 62 of the 86 patients who responded were on AED monotherapy. All 62 pregnancies reported were singleton. 55 infants (88%) were exposed to newer AEDs and 7 infants (12%) to older AEDs. Amongst the newer AEDs group, 24 fetuses (38%) were exposed to lamotrigine, 11 fetuses (18%) to levetiracetam, 17 fetuses (27%) to carbamazepine, 2 fetuses (3%) to topiramate and 1 fetus (1.5%) to gabapentin. There were 55 (88%) live births and 7 unsuccessful pregnancies (miscarriages/stillbirths). Unsuccessful pregnancies were reported in 2 gestations exposed to lamotrigine (8%), 2 to levetiracetam (18%) and 3 to carbamazepine (17%). Abnormal developmental outcomes were defined as delayed motor development or speech delay requiring therapy and special education. Abnormal development was noted in 2 children prenatally exposed to lamotrigine (8%), 3 exposed to carbamazepine (17%) and 1 child exposed to valproate (50%). All children with abnormal development were exposed to folate throughout pregnancy. There were no major malformations in any of the infants.

Conclusions Our cohort group of children exposed to newer AEDs in utero demonstrated successful pregnancy outcomes compared to the older AED group. Our study population is small, but would lead us to feel comfortable with prescribing newer AEDs to WWE as they are planning pregnancy.

Authors/Disclosures
Dimitrios Arkilo, MD PRESENTER	Dr. Arkilo has received personal compensation for serving as an employee of Sage Therapeutics. Dr. Arkilo has received personal compensation for serving as an employee of Acadia Pharmaceuticals. Dr. Arkilo has received personal compensation for serving as an employee of Takeda Pharmaceuticals. Dr. Arkilo has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EcoR1. An immediate family member of Dr. Arkilo has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbvie. An immediate family member of Dr. Arkilo has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Medtronic. Dr. Arkilo has stock in Takeda Pharmaceuticals. Dr. Arkilo has stock in Acadia Pharmaceuticals. Dr. Arkilo has stock in Sage Therapeutics.
Angel R. Chinea, MD	Dr. Chinea has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for novartis. Dr. Chinea has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for biogen. Dr. Chinea has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for emd serono. Dr. Chinea has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for genentech. Dr. Chinea has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for sanofi. Dr. Chinea has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for biogen. Dr. Chinea has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Novartis. Dr. Chinea has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for emd serono. Dr. Chinea has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for sanofi. Dr. Chinea has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Genentech. Dr. Chinea has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for allergan.
Julie Estelle M. Hanna, MD (Minnesota Epilepsy Group)	No disclosure on file
Deanna Dickens, MD (West Palm Beach VAMC)	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Patricia E. Penovich, MD, FAAN	Dr. Penovich has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Engage therapeutics. Dr. Penovich has received personal compensation in the range of $0-$499 for serving as a Consultant for LVIS. Dr. Penovich has received personal compensation in the range of $0-$499 for serving as a Consultant for Monteris. Dr. Penovich has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for SK Therapeutics. Dr. Penovich has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Neurelis. Dr. Penovich has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Greenwich. Dr. Penovich has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for SK Biosciences. Dr. Penovich has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Neurelis. Dr. Penovich has a non-compensated relationship as a Comittee Member with American Epilepsy Society that is relevant to AAN interests or activities.

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