Title

Teratogenesis, Perinatal, and Neurodevelopmental Outcomes After In Utero Exposure to Antiseizure Medication

Authoring Organizations

American Academy of Neurology

American Epilepsy Society

Publication Month/Year

May 15, 2024

Last Updated Month/Year

October 10, 2024

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Document Objectives

To reassess the evidence for management issues related to the care of women with epilepsy (WWE) during pregnancy.

Target Patient Population

Pregnant women with epilepsy

PICO Questions

  1. What is the prevalence of major congenital malformations (MCMs) associated with intrauterine exposure to specific anti-seizure medications (ASMs), and how does this vary between ASMs in monotherapy versus polytherapy, and at high doses versus low-to-medium doses of ASMs, in children born to pregnant women with epilepsy and concomitant psychiatric disorders (PWECP)?

  2. What is the prevalence of adverse perinatal outcomes associated with intrauterine exposure to specific anti-seizure medications (ASMs), and how does this vary between ASMs in monotherapy versus polytherapy, and at high doses versus low-to-medium doses of ASMs, in children born to pregnant women with epilepsy and concomitant psychiatric disorders (PWECP)?

  3. What is the prevalence of adverse neurodevelopmental outcomes associated with intrauterine exposure to specific anti-seizure medications (ASMs), and how does this vary between ASMs in monotherapy versus polytherapy, and at high versus low-to-medium doses of ASMs, in children born to pregnant women with epilepsy and concomitant psychiatric disorders (PWECP)?

  4. What is the effect of intrauterine exposure to folic acid on the prevalence of major congenital malformations (MCMs), adverse perinatal outcomes, and neurodevelopmental outcomes, and how does this vary by folic acid dose in children born to pregnant women with epilepsy and concomitant psychiatric disorders (PWECP) treated with anti-seizure medications (ASMs)?

Inclusion Criteria

Adolescent, Adult

Health Care Settings

Ambulatory, Hospital, Outpatient, Operating and recovery room

Intended Users

Nurse, nurse practitioner, occupational therapist, physician, physician assistant

Scope

Management

Diseases/Conditions (MeSH)

D004827 - Epilepsy, D018743 - Perinatal Care, D064793 - Teratogenesis

Keywords

antiepileptic drug, women with epilepsy, Teratogenesis, perinatal outcomes

Source Citation

Pack AM, Oskoui M, Williams Roberson S, et al. Teratogenesis, perinatal, and neurodevelopmental outcomes after in utero exposure to antiseizure medication: Practice guideline from the AAN, AES, and SMFM. Neurology. 2024;102(11). doi:10.1212/WNL.0000000000209279

Supplemental Methodology Resources

Data Supplement, Data Supplement, Data Supplement

Methodology

Number of Source Documents
135
Literature Search Start Date
June 1, 2007
Literature Search End Date
August 1, 2022