Updates on Anti-seizure Medication Use in Pregnancy

AbstractPurpose of ReviewCare of people with epilepsy and gestational capacity throughout pregnancy involves weighing risks of seizures with the known risks of anti-seizure medications, and requires planning and patient counseling.Recent FindingsAnti-seizure medications are associated with increased risk of congenital malformations. Further study is needed to understand the risk profile of newer anti-seizure medications in pregnancy. Cognitive outcomes of infants exposed to anti-seizure medications in utero vary, but valproate is associated with an increased risk of cognitive teratogenesis. Topiramate may also have an adverse neurodevelopmental effect though data are conflicting. Anti-seizure medication concentrations fall during pregnancy, so therapeutic drug monitoring and dose adjustment are needed during pregnancy. Peri-conceptual folic acid supplementation has benefits, but the best dose is not known. Anti-seizure medications get into breastmilk, though infant levels are lower than maternal levels and breastfeeding in recommended.SummaryRecent research highlights that anti-seizure medications have both structural and cognitive teratogenic potential. Further studies into newer anti-seizure medications as well as folic acid dosing are needed to optimize the care of people with epilepsy and gestational capacity throughout pregnancy.
Source: Current Obstetrics and Gynecology Reports - Category: OBGYN Source Type: research