GuidelineNeurology2009
Practice parameter update: management issues for women with epilepsy--focus on pregnancy (an evidence-based review): teratogenesis and perinatal outcomes [RETIRED]: report of the Quality Standards Subcommittee and Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and American Epilepsy Society.
Guideline in Neurology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 92 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
92 citing papers in PubMed, 3 syntheses or guidelines pooled it, 427 citations in OpenAlex.
- Recurrence rate and risk factors of recurrence after antiseizure medications withdrawal in children with epilepsy: a meta-analysis.Frontiers in pediatrics · 2026Pooled it
- Guideline
- Guideline
- Fetal antiepileptic drug exposure and cognitive outcomes at age 6 years (NEAD study): a prospective observational study.The Lancet. Neurology · 2013Trial
- A Novel Approach of Development of Robust Animal Model for Autism Spectrum Disorder.Annals of neurosciences · 2026Article
- Review
- Evidence of Sex-Related Pharmacodynamic Differences in Photosensitive Epilepsy Treated with Valproate: Findings from a Retrospective, Observational, Single-Center, Within-Patient, Cohort Study.Drugs - real world outcomes · 2025Article
- Pre-pregnancy fertility guidance for women of childbearing age with epilepsy: A scoping review.International journal of nursing studies advances · 2025Review
- The use of antiepileptic drugs and their effects in pregnancy.Turkish journal of medical sciences · 2025Article
- The Effect of Seizures on Perinatal Outcomes in Pregnant Women with Epilepsy: A Single Center Retrospective Study.International journal of women's health · 2025Article
- What do women with epilepsy know about pregnancy?South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2024Article
- Prescribing Trends of Antiseizure Drugs in Women Veterans With Epilepsy.Military medicine · 2023Article
- Black-Box Warnings of Antiseizure Medications: What is Inside the Box?Pharmaceutical medicine · 2023Review
- Economic Evaluation of the Community Benefit of the Australian Pregnancy Register of Antiseizure Medications.Neurology · 2023Observational
- A case of migraine misdiagnosed as epilepsy.Acta epileptologica · 2023Article
- Distribution and risk factors of cleft lip and palate on patients from a sample of Damascus hospitals - A case-control study.Heliyon · 2021Article
- Anti-epileptic drug exposure during pregnancy and neonatal birth weight outcomes: protocol for a systematic review and meta-analysis.Systematic reviews · 2021Article
- Neurocognitive Effects of Antiseizure Medications in Children and Adolescents with Epilepsy.Paediatric drugs · 2021Review
- A nationwide analysis of maternal morbidity and acute postpartum readmissions in women with epilepsy.Epilepsy & behavior : E&B · 2021Article
- Article
32 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
24 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveTo reassess the evidence for management issues related to the care of women with epilepsy (WWE) during pregnancy.
methodsSystematic review of relevant articles published between January 1985 and June 2007.
resultsIt is highly probable that intrauterine first-trimester valproate (VPA) exposure has higher risk of major congenital malformations (MCMs) compared to carbamazepine and possible compared to phenytoin or lamotrigine. Compared to untreated WWE, it is probable that VPA as part of polytherapy and possible that VPA as monotherapy contribute to the development of MCMs. It is probable that antiepileptic drug (AED) polytherapy as compared to monotherapy regimens contributes to the development of MCMs and to reduced cognitive outcomes. For monotherapy, intrauterine exposure to VPA probably reduces cognitive outcomes. Further, monotherapy exposure to phenytoin or phenobarbital possibly reduces cognitive outcomes. Neonates of WWE taking AEDs probably have an increased risk of being small for gestational age and possibly have an increased risk of a 1-minute Apgar score of <7. RECOMMENDATIONS: If possible, avoidance of valproate (VPA) and antiepileptic drug (AED) polytherapy during the first trimester of pregnancy should be considered to decrease the risk of major congenital malformations (Level B). If possible, avoidance of VPA and AED polytherapy throughout pregnancy should be considered to prevent reduced cognitive outcomes (Level B). If possible, avoidance of phenytoin and phenobarbital during pregnancy may be considered to prevent reduced cognitive outcomes (Level C). Pregnancy risk stratification should reflect that the offspring of women with epilepsy taking AEDs are probably at increased risk for being small for gestational age (Level B) and possibly at increased risk of 1-minute Apgar scores of <7 (Level C).
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.