Evidence map›Paper›PMID 41804083›Full record

ArticleEpilepsia2026

Did the French pregnancy pictogram change antiseizure medication use during pregnancy?

Mélanie Araujo, Christine Damase-Michel, Marie Denuelle, Sébastien Boulogne, Laurane Delteil, Monica Saucedo, Catherine Deneux-Tharaux, Isabelle Lacroix

Abstract read
In one paragraph

Article in Epilepsia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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

8 authors.

Mélanie AraujoFaculté de Médecine de Toulouse, Centre Hospitalier Universitaire de Toulouse, Institut National de la Santé et de la Recherche Médicale (INSERM) Unité Mixte de Recherche (UMR) 1295, Toulouse, France.ORCID https://orcid.org/0000-0003-3057-9554
Christine Damase-MichelFaculté de Médecine de Toulouse, Centre Hospitalier Universitaire de Toulouse, Institut National de la Santé et de la Recherche Médicale (INSERM) Unité Mixte de Recherche (UMR) 1295, Toulouse, France.ORCID https://orcid.org/0000-0001-5018-0108
Marie DenuelleElectrophysiologie Cérébrale, Épilepsie et Sommeil, Hôpital Pierre Paul Riquet, CHU Purpan, Toulouse, France.ORCID https://orcid.org/0000-0001-8692-1262
Sébastien BoulogneService de Neurologie Fonctionnelle et d'épileptologie, Groupement Hospitalier Est-Hôpital Pierre Wertheimer, Bron, France.ORCID https://orcid.org/0000-0001-8681-7369
Laurane DelteilFaculté de Médecine de Toulouse, Centre Hospitalier Universitaire de Toulouse, Institut National de la Santé et de la Recherche Médicale (INSERM) Unité Mixte de Recherche (UMR) 1295, Toulouse, France.ORCID https://orcid.org/0009-0004-2149-713X
Monica SaucedoInstitut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Center for Research in Epidemiology and Statistics, Obstetrical Perinatal and Pediatric Life Course Epidemiology, Université Paris Cité, Université Paris Nord, Paris, France.ORCID https://orcid.org/0000-0003-1213-5693
Catherine Deneux-TharauxInstitut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Center for Research in Epidemiology and Statistics, Obstetrical Perinatal and Pediatric Life Course Epidemiology, Université Paris Cité, Université Paris Nord, Paris, France.ORCID https://orcid.org/0000-0002-6561-3321
Isabelle LacroixFaculté de Médecine de Toulouse, Centre Hospitalier Universitaire de Toulouse, Institut National de la Santé et de la Recherche Médicale (INSERM) Unité Mixte de Recherche (UMR) 1295, Toulouse, France.ORCID https://orcid.org/0000-0001-7344-7282

Funding

ANSM (French National Agency for the Safety of Medicines and Health Products)CNAM (French National Health Insurance Fund)EPI-PHARE EC 2021-07
6 · The paper itself

Abstract

objectiveThe aim of this study was to assess the impact of introducing a pregnancy pictogram on medication packaging on the prescription and dispensation of antiseizure medications and on the maternal and neonatal outcomes for women exposed to these medications.

methodsThis is a national retrospective cohort study, based on the French National Health Data System, with a "before/after the introduction of the pictogram" design. Women aged between 15 and 55 years who had a pregnancy outcome between 2014 and 2017 ("before pictogram" period) and between 2018 and 2021 ("after pictogram" period) and who had received at least two antiseizure medication dispensations before their pregnancy were included. We compared the rates of antiseizure medication discontinuation and continuation during pregnancy, the average doses used, and maternal and neonatal outcomes between the two periods.

resultsThe rate of women who had received at least two dispensations of a medication indicated for epilepsy before their pregnancy remained stable between the two periods (.7%). There was a significant decrease in valproic acid prescriptions (5.4% vs. 1.3%) during pregnancy and, conversely, an increase in lamotrigine (29.9% vs. 31.5%) and levetiracetam (10.9% vs. 14.5%) prescriptions. Prescriptions by specialists such as neurologists increased significantly (22.8% vs. 28%) between the two periods. There was an increase of more than 2.7% in the continuation of antiseizure medication (37.6% vs. 40.3%, p < .0001) and conversely a decrease in the rate of women who stopped their antiseizure treatment before or during pregnancy in the "after pictogram" period (59.4% vs. 56.7%, p < .0001). Rates of maternal and neonatal outcomes remained similar between the two periods. SIGNIFICANCE: The introduction of a pregnancy pictogram in France in 2017 was not associated with an increase in discontinuation of antiseizure medications, less adequate treatment, or poorer maternal or neonatal outcomes in pregnant women receiving these medications before pregnancy.

Indexed as

AnticonvulsantsDrug LabelingEpilepsyPregnancy ComplicationsAdolescentAdultFemaleFranceHumansLamotrigineLevetiracetamMiddle AgedPregnancyPregnancy OutcomeRetrospective StudiesValproic AcidAnticonvulsantsLamotrigineLevetiracetamValproic Acidantiseizure medicationsimpact studypictogrampregnancySNDS database

Identifiers

PMID41804083
PMCPMC13285228

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Registered trials

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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.