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Exposure to medication for neurological disease in pregnancy - time to consider the long-term implications?

作者信息

Liu Chen, Pace Samuel, Bromley Rebecca, Dobson Ruth

机构信息

Preventive Neurology Unit, Wolfson Institute of Population Health, QMUL, UK.

Department of Neurology, Royal London Hospital, Barts Health NHS Trust, London, UK.

出版信息

EClinicalMedicine. 2023 Aug 24;63:102157. doi: 10.1016/j.eclinm.2023.102157. eCollection 2023 Sep.


DOI:10.1016/j.eclinm.2023.102157
PMID:37662523
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10474373/
Abstract

A range of long-term neurological conditions may be diagnosed in young adulthood. These conditions are generally not curable, and most people need to take ongoing treatment for symptom control and/or disease modification. When chronic diseases are diagnosed before people have completed their families, there is a need to balance the potential benefits of treatment for the mother against potential risk(s) to the fetus from exposure to medications during pregnancy. Whilst available data regarding short-term fetal outcomes following treatment exposures during pregnancy is rapidly increasing, information regarding longer-term outcomes is more limited. The association of fetal exposure to valproate with serious long-term neurodevelopmental outcomes has highlighted the importance of capturing and evaluating long-term data. In this review we examine available evidence around the long-term effects of treatments used for the most common long-term neurological conditions diagnosed in early adulthood, namely epilepsy, migraine and neuroinflammatory disorders. We draw from existing literature across a range of diseases and discuss strategies to improve future knowledge.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23c8/10474373/b8f87af0611a/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23c8/10474373/b8f87af0611a/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23c8/10474373/b8f87af0611a/gr1.jpg

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本文引用的文献

[1]
Expert consensus on neurodevelopmental outcomes in pregnancy pharmacovigilance studies.

Front Pharmacol. 2023-6-1

[2]
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Lancet Neurol. 2023-4

[3]
Expected impact of immunomodulatory agents during pregnancy: A newborn's perspective.

Pediatr Allergy Immunol. 2023-2

[4]
Adaptive behaviour in children exposed to topiramate in the womb: An observational cohort study.

Seizure. 2023-2

[5]
Breastfeeding while on treatment with antiseizure medications: a systematic review from the ILAE Women Task Force.

Epileptic Disord. 2022-12-1

[6]
Exposure to natalizumab throughout pregnancy: effectiveness and safety in an Italian cohort of women with multiple sclerosis.

J Neurol Neurosurg Psychiatry. 2022-9-30

[7]
Outcomes of children born to mothers with systemic lupus erythematosus exposed to hydroxychloroquine or azathioprine.

Rheumatology (Oxford). 2023-3-1

[8]
Association of Maternal Use of Triptans During Pregnancy With Risk of Attention-Deficit/Hyperactivity Disorder in Offspring.

JAMA Netw Open. 2022-6-1

[9]
Association of Prenatal Exposure to Antiseizure Medication With Risk of Autism and Intellectual Disability.

JAMA Neurol. 2022-7-1

[10]
The use of erenumab for migraine prophylaxis during pregnancy: A case report and narrative review.

Headache. 2022-11

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