Traduction partielle: G.M.
J Pediatr Genet. 2015 Jun;4(2):94-110. doi: 10.1055/s-0035-1556741.
An Update on Maternal Use of Antiepileptic Medications in Pregnancy and Neurodevelopment Outcomes
Author information
- 1Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States.
- 2Department of Neurology and Neurological Sciences, Stanford University, Stanford, California, United States.
Abstract
Les médicaments antiépileptiques (DEA) sont prescrits couramment aux femmes en âge de procréer.L'exposition in utero à certains antiépileptiques peut avoir des conséquences cognitives et comportementales importantes pour l'enfant à naître. Récemment, des études prospectives de femmes prenant des antiépileptiques pendant la grossesse sont venues s'ajouter de manière significative à notre compréhension des risques tératogènes cognitifs et comportementaux liés à l'exposition foetal aux AED . Le valproate est clairement associé au développement cognitif, ainsi qu'à un risque accru de troubles tels que des troubles du spectre de l'autisme et l'autisme. L'exposition à la carbamazépine, lamotrigine, lévétiracétam, ou la phénytoïne en monothérapie est associée à des résultats cognitifs et comportementaux plus favorables que le valproate, mais davantage de données sont nécessaires pour préciser si ces antiépileptiques ont des effets plus subtils sur la cognition et le comportement. Il n'y a pas suffisamment de données sur les effets sur le développement des autres antiépileptiques chez l'homme. En outre, les mécanismes sous-jacents de la tératogenèse cognitive sont mal compris, y compris les facteurs génétiques qui affectent la sensibilité aux antiépileptiques.
Antiepileptic drugs (AEDs) are prescribed commonly to women of childbearing age. In utero exposure to some AEDs can have significant cognitive and behavioral consequences for the unborn child. Recently, prospective studies of women taking AEDs during pregnancy have added significantly to our understanding of cognitive and behavioral teratogenic risks posed by fetal AED exposure. Valproate is clearly associated with impaired cognitive development as well as an increased risk of disorders such as autism and autism spectrum disorder. Exposure to carbamazepine, lamotrigine, levetiracetam, or phenytoin monotherapy is associated with more favorable cognitive and behavioral outcomes than valproate, but more data are required to clarify if these AEDs have more subtle effects on cognition and behavior. There are insufficient data on the developmental effects of other AEDs in humans. Further, the underlying mechanisms of cognitive teratogenesis are poorly understood, including the genetic factors that affect susceptibility to AEDs.
Antiepileptic drugs (AEDs) are prescribed commonly to women of childbearing age. In utero exposure to some AEDs can have significant cognitive and behavioral consequences for the unborn child. Recently, prospective studies of women taking AEDs during pregnancy have added significantly to our understanding of cognitive and behavioral teratogenic risks posed by fetal AED exposure. Valproate is clearly associated with impaired cognitive development as well as an increased risk of disorders such as autism and autism spectrum disorder. Exposure to carbamazepine, lamotrigine, levetiracetam, or phenytoin monotherapy is associated with more favorable cognitive and behavioral outcomes than valproate, but more data are required to clarify if these AEDs have more subtle effects on cognition and behavior. There are insufficient data on the developmental effects of other AEDs in humans. Further, the underlying mechanisms of cognitive teratogenesis are poorly understood, including the genetic factors that affect susceptibility to AEDs.
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