Differential effects of antiepileptic drugs on neonatal outcomes

P. B. Pennell, A. M. Klein, N. Browning, G. A. Baker, J. Clayton-Smith, L. A. Kalayjian, J. D. Liporace, M. Privitera, T. Crawford, D. W. Loring, K. J. Meador, David Labiner, Jennifer Moon, Scott Sherman, Deborah T.C. Cantrell, Cheryl Silver, Monisha Goyal, Mike R. Schoenberg, Alison Pack, Christina Palmese & 85 others Joyce Echo, Kimford J. Meador, David Loring, Page Pennell, Daniel Drane, Eugene Moore, Megan Denham, Charles Epstein, Jennifer Gess, Sandra Helmers, Thomas Henry, Gholam Motamedi, Erin Flax, Edward Bromfield, Katrina Boyer, Barbara Dworetzky, Andrew Cole, Lucila Halperin, Sara Shavel-Jessop, Gregory Barkley, Barbara Moir, Cynthia Harden, Tara Tamny-Young, Gregory P Lee, Patricia Penovich, Donna Minter, Layne Moore, Kathryn Murdock, Joyce Liporace, Kathryn Wilcox, Andres Kanner, Michael N. Nelson, William Rosenfeld, Michelle Meyer, Jill Clayton-Smith, George Mawer, Usha Kini, Roy Martin, Michael Privitera, Jennifer Bellman, David Ficker, Lyle Baade, Kore Liow, Alison Booth, Rebecca Bromley, Miranda Casswell, Claire Barrie, Eugene Ramsay, Patricia Arena, Laura Kalayjian, Christianne Heck, Sonia Padilla, John Miller, Gail Rosenbaum, Alan Wilensky, Tawnya Constantino, Julien Smith, Naghme Adab, Gisela Veling-Warnke, Maria Sam, Cormac O'Donovan, Cecile Naylor, Shelli Nobles, Cesar Santos, Gregory L. Holmes, Maurice Druzin, Martha Morrell, Lorene Nelson, Richard Finnell, Mark Yerby, Khosrow Adeli, Peter Wells, Nancy Browning, Temperance Blalock, Todd Crawford, Linda Hendrickson, Bernadette Jolles, Meghan Kelly Kunchai, Hayley Loblein, Yinka Ogunsola, Steve Russell, Jamie Winestone, Mark Wolff, Phyllis Zaia, Thad Zajdowicz

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Offspring of women with epilepsy (WWE) on AEDs are at increased risks for major congenital malformations and reduced cognition. They may be at risk for other adverse neonatal outcomes. Women with epilepsy on carbamazepine (CBZ), lamotrigine (LTG), phenytoin (PHT), or valproate (VPA) monotherapy were enrolled in a prospective, observational, multicenter study of the neurodevelopmental effects of AEDs. The odds ratio for small for gestational age (SGA) was higher for VPA vs. PHT, VPA vs. LTG, and CBZ vs. PHT. Microcephaly rates were elevated to 12% for all newborns and at 12. months old, but normalized by age 24. months. Reduced Apgar scores occurred more frequently in the VPA and PHT groups at 1. min, but scores were near normal in all groups at 5. min. This study demonstrates increased risks for being born SGA in the VPA and CBZ groups, and transiently reduced Apgar scores in the VPA and PHT groups. Differential risks among the AEDs can help inform decisions about AED selection for women during childbearing years.

Original languageEnglish (US)
Pages (from-to)449-456
Number of pages8
JournalEpilepsy and Behavior
Volume24
Issue number4
DOIs
StatePublished - Aug 1 2012

Fingerprint

Valproic Acid
Anticonvulsants
Phenytoin
Carbamazepine
Apgar Score
Gestational Age
Epilepsy
Microcephaly
Cognition
Multicenter Studies
Observational Studies
Odds Ratio
Newborn Infant

Keywords

  • Antiepileptic drugs
  • Apgar
  • Epilepsy
  • Microcephaly
  • Neonatal
  • Observational cohort study
  • Pregnancy
  • Seizures
  • Small for gestational age (SGA)

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Behavioral Neuroscience

Cite this

Pennell, P. B., Klein, A. M., Browning, N., Baker, G. A., Clayton-Smith, J., Kalayjian, L. A., ... Zajdowicz, T. (2012). Differential effects of antiepileptic drugs on neonatal outcomes. Epilepsy and Behavior, 24(4), 449-456. https://doi.org/10.1016/j.yebeh.2012.05.010

Differential effects of antiepileptic drugs on neonatal outcomes. / Pennell, P. B.; Klein, A. M.; Browning, N.; Baker, G. A.; Clayton-Smith, J.; Kalayjian, L. A.; Liporace, J. D.; Privitera, M.; Crawford, T.; Loring, D. W.; Meador, K. J.; Labiner, David; Moon, Jennifer; Sherman, Scott; Cantrell, Deborah T.C.; Silver, Cheryl; Goyal, Monisha; Schoenberg, Mike R.; Pack, Alison; Palmese, Christina; Echo, Joyce; Meador, Kimford J.; Loring, David; Pennell, Page; Drane, Daniel; Moore, Eugene; Denham, Megan; Epstein, Charles; Gess, Jennifer; Helmers, Sandra; Henry, Thomas; Motamedi, Gholam; Flax, Erin; Bromfield, Edward; Boyer, Katrina; Dworetzky, Barbara; Cole, Andrew; Halperin, Lucila; Shavel-Jessop, Sara; Barkley, Gregory; Moir, Barbara; Harden, Cynthia; Tamny-Young, Tara; Lee, Gregory P; Penovich, Patricia; Minter, Donna; Moore, Layne; Murdock, Kathryn; Liporace, Joyce; Wilcox, Kathryn; Kanner, Andres; Nelson, Michael N.; Rosenfeld, William; Meyer, Michelle; Clayton-Smith, Jill; Mawer, George; Kini, Usha; Martin, Roy; Privitera, Michael; Bellman, Jennifer; Ficker, David; Baade, Lyle; Liow, Kore; Booth, Alison; Bromley, Rebecca; Casswell, Miranda; Barrie, Claire; Ramsay, Eugene; Arena, Patricia; Kalayjian, Laura; Heck, Christianne; Padilla, Sonia; Miller, John; Rosenbaum, Gail; Wilensky, Alan; Constantino, Tawnya; Smith, Julien; Adab, Naghme; Veling-Warnke, Gisela; Sam, Maria; O'Donovan, Cormac; Naylor, Cecile; Nobles, Shelli; Santos, Cesar; Holmes, Gregory L.; Druzin, Maurice; Morrell, Martha; Nelson, Lorene; Finnell, Richard; Yerby, Mark; Adeli, Khosrow; Wells, Peter; Browning, Nancy; Blalock, Temperance; Crawford, Todd; Hendrickson, Linda; Jolles, Bernadette; Kunchai, Meghan Kelly; Loblein, Hayley; Ogunsola, Yinka; Russell, Steve; Winestone, Jamie; Wolff, Mark; Zaia, Phyllis; Zajdowicz, Thad.

In: Epilepsy and Behavior, Vol. 24, No. 4, 01.08.2012, p. 449-456.

Research output: Contribution to journalArticle

Pennell, PB, Klein, AM, Browning, N, Baker, GA, Clayton-Smith, J, Kalayjian, LA, Liporace, JD, Privitera, M, Crawford, T, Loring, DW, Meador, KJ, Labiner, D, Moon, J, Sherman, S, Cantrell, DTC, Silver, C, Goyal, M, Schoenberg, MR, Pack, A, Palmese, C, Echo, J, Meador, KJ, Loring, D, Pennell, P, Drane, D, Moore, E, Denham, M, Epstein, C, Gess, J, Helmers, S, Henry, T, Motamedi, G, Flax, E, Bromfield, E, Boyer, K, Dworetzky, B, Cole, A, Halperin, L, Shavel-Jessop, S, Barkley, G, Moir, B, Harden, C, Tamny-Young, T, Lee, GP, Penovich, P, Minter, D, Moore, L, Murdock, K, Liporace, J, Wilcox, K, Kanner, A, Nelson, MN, Rosenfeld, W, Meyer, M, Clayton-Smith, J, Mawer, G, Kini, U, Martin, R, Privitera, M, Bellman, J, Ficker, D, Baade, L, Liow, K, Booth, A, Bromley, R, Casswell, M, Barrie, C, Ramsay, E, Arena, P, Kalayjian, L, Heck, C, Padilla, S, Miller, J, Rosenbaum, G, Wilensky, A, Constantino, T, Smith, J, Adab, N, Veling-Warnke, G, Sam, M, O'Donovan, C, Naylor, C, Nobles, S, Santos, C, Holmes, GL, Druzin, M, Morrell, M, Nelson, L, Finnell, R, Yerby, M, Adeli, K, Wells, P, Browning, N, Blalock, T, Crawford, T, Hendrickson, L, Jolles, B, Kunchai, MK, Loblein, H, Ogunsola, Y, Russell, S, Winestone, J, Wolff, M, Zaia, P & Zajdowicz, T 2012, 'Differential effects of antiepileptic drugs on neonatal outcomes', Epilepsy and Behavior, vol. 24, no. 4, pp. 449-456. https://doi.org/10.1016/j.yebeh.2012.05.010
Pennell PB, Klein AM, Browning N, Baker GA, Clayton-Smith J, Kalayjian LA et al. Differential effects of antiepileptic drugs on neonatal outcomes. Epilepsy and Behavior. 2012 Aug 1;24(4):449-456. https://doi.org/10.1016/j.yebeh.2012.05.010
Pennell, P. B. ; Klein, A. M. ; Browning, N. ; Baker, G. A. ; Clayton-Smith, J. ; Kalayjian, L. A. ; Liporace, J. D. ; Privitera, M. ; Crawford, T. ; Loring, D. W. ; Meador, K. J. ; Labiner, David ; Moon, Jennifer ; Sherman, Scott ; Cantrell, Deborah T.C. ; Silver, Cheryl ; Goyal, Monisha ; Schoenberg, Mike R. ; Pack, Alison ; Palmese, Christina ; Echo, Joyce ; Meador, Kimford J. ; Loring, David ; Pennell, Page ; Drane, Daniel ; Moore, Eugene ; Denham, Megan ; Epstein, Charles ; Gess, Jennifer ; Helmers, Sandra ; Henry, Thomas ; Motamedi, Gholam ; Flax, Erin ; Bromfield, Edward ; Boyer, Katrina ; Dworetzky, Barbara ; Cole, Andrew ; Halperin, Lucila ; Shavel-Jessop, Sara ; Barkley, Gregory ; Moir, Barbara ; Harden, Cynthia ; Tamny-Young, Tara ; Lee, Gregory P ; Penovich, Patricia ; Minter, Donna ; Moore, Layne ; Murdock, Kathryn ; Liporace, Joyce ; Wilcox, Kathryn ; Kanner, Andres ; Nelson, Michael N. ; Rosenfeld, William ; Meyer, Michelle ; Clayton-Smith, Jill ; Mawer, George ; Kini, Usha ; Martin, Roy ; Privitera, Michael ; Bellman, Jennifer ; Ficker, David ; Baade, Lyle ; Liow, Kore ; Booth, Alison ; Bromley, Rebecca ; Casswell, Miranda ; Barrie, Claire ; Ramsay, Eugene ; Arena, Patricia ; Kalayjian, Laura ; Heck, Christianne ; Padilla, Sonia ; Miller, John ; Rosenbaum, Gail ; Wilensky, Alan ; Constantino, Tawnya ; Smith, Julien ; Adab, Naghme ; Veling-Warnke, Gisela ; Sam, Maria ; O'Donovan, Cormac ; Naylor, Cecile ; Nobles, Shelli ; Santos, Cesar ; Holmes, Gregory L. ; Druzin, Maurice ; Morrell, Martha ; Nelson, Lorene ; Finnell, Richard ; Yerby, Mark ; Adeli, Khosrow ; Wells, Peter ; Browning, Nancy ; Blalock, Temperance ; Crawford, Todd ; Hendrickson, Linda ; Jolles, Bernadette ; Kunchai, Meghan Kelly ; Loblein, Hayley ; Ogunsola, Yinka ; Russell, Steve ; Winestone, Jamie ; Wolff, Mark ; Zaia, Phyllis ; Zajdowicz, Thad. / Differential effects of antiepileptic drugs on neonatal outcomes. In: Epilepsy and Behavior. 2012 ; Vol. 24, No. 4. pp. 449-456.
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AU - Liporace, J. D.

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AU - Booth, Alison

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AU - Casswell, Miranda

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AU - Nelson, Lorene

AU - Finnell, Richard

AU - Yerby, Mark

AU - Adeli, Khosrow

AU - Wells, Peter

AU - Browning, Nancy

AU - Blalock, Temperance

AU - Crawford, Todd

AU - Hendrickson, Linda

AU - Jolles, Bernadette

AU - Kunchai, Meghan Kelly

AU - Loblein, Hayley

AU - Ogunsola, Yinka

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AB - Offspring of women with epilepsy (WWE) on AEDs are at increased risks for major congenital malformations and reduced cognition. They may be at risk for other adverse neonatal outcomes. Women with epilepsy on carbamazepine (CBZ), lamotrigine (LTG), phenytoin (PHT), or valproate (VPA) monotherapy were enrolled in a prospective, observational, multicenter study of the neurodevelopmental effects of AEDs. The odds ratio for small for gestational age (SGA) was higher for VPA vs. PHT, VPA vs. LTG, and CBZ vs. PHT. Microcephaly rates were elevated to 12% for all newborns and at 12. months old, but normalized by age 24. months. Reduced Apgar scores occurred more frequently in the VPA and PHT groups at 1. min, but scores were near normal in all groups at 5. min. This study demonstrates increased risks for being born SGA in the VPA and CBZ groups, and transiently reduced Apgar scores in the VPA and PHT groups. Differential risks among the AEDs can help inform decisions about AED selection for women during childbearing years.

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KW - Apgar

KW - Epilepsy

KW - Microcephaly

KW - Neonatal

KW - Observational cohort study

KW - Pregnancy

KW - Seizures

KW - Small for gestational age (SGA)

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