Evidence map›Paper›PMID 27502786›Full record

ReviewNeurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics2016

Use of Antiepileptic Drugs During Pregnancy: Evolving Concepts.

Page B Pennell

Open access · bronzeAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed
13.7field-weighted citation impact, top 1% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 64 citations in OpenAlex.

  1. Observational
  2. Review
  3. Review
  4. Review
  5. Review
  6. Article
  7. Review
  8. Article
  9. Epilepsy in Pregnancy-Management Principles and Focus on Valproate.International journal of molecular sciences · 2022
    Review
  10. Article
  11. Review
  12. Review
  13. Observational
  14. Review
  15. Article
  16. Observational
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

1 author at 1 institution in 1 country.

Page B PennellDepartment of Neurology, Division of Epilepsy, Division of Women's Health, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, 02115, USA. PPENNELL@BWH.HARVARD.EDU.
Brigham and Women's Hospital · US

Funding

Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD)U01NS038455 · NINDS · STANFORD UNIVERSITY · PI MATTHEWS, ABIGAIL GOREN, MEADOR, KIMFORD J · 2012 to 2022
$27.7M
NINDS NIH HHS U01 NS038455
6 · The paper itself

Abstract

Although prenatal exposure to antiepileptic drugs (AEDs) is known to impart relatively higher risks of major congenital malformations, prospective studies have provided refined data that allow us to differentiate the risks of different types and doses of AEDs. As the number of AED prescriptions has dramatically increased in reproductive-aged women with a variety of neuropsychiatric indications, the evolving concepts learned from studies in women with epilepsy can be applied to a much larger group of pregnant women to improve child outcomes while maintaining maternal disease control. In addition to careful selection of the type of medication, the amount of fetal exposure at conception and in the first trimester probably matters across all AEDs. Some AED polytherapy regimens are not associated with a higher risk of malformations, although other outcomes have not yet been formally studied. The individual woman's drug target concentration should be established preconception and maintained during pregnancy, to prevent seizure worsening. Substantial pharmacokinetic changes occur with many of the medications during pregnancy and postpartum, and interindividual variability supports the use of therapeutic drug monitoring for most AEDs. During pregnancy, vigilance and close monitoring should also include intrauterine fetal growth, obstetric complications, and neonatal complications. Breastfeeding can provide additional neurodevelopmental benefit and should be an option for women on AEDs. Knowledge of these key principles enhances our ability to make treatment recommendations with resultant improved maternal and child outcomes. Additional prospective studies are needed to further define the risk-benefit ratio across a variety of medications, dosing strategies, and neuropsychiatric disorders.

Indexed as

AnticonvulsantsEpilepsyFemaleHumansNeurodevelopmental DisordersPrecision MedicinePregnancyPregnancy ComplicationsAnticonvulsantsAntiepileptic drugsBreastfeedingEpilepsyNeuropsychiatric disordersPregnancy

Identifiers

PMID27502786
PMCPMC5081129
OpenAlexW2513615046

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.