Antiepileptic drugs and pregnancy outcomes.
Antiepileptic drugs and pregnancy outcomes.
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DOI：
10.1002/ajmg.a.35438
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发表时间：
2012-08
影响因子：
2
通讯作者：
Finnell, Richard H.
中科院分区：
文献类型：
--
作者：
Wlodarczyk, Bogdan J.;Palacios, Ana M.;George, Timothy M.;Finnell, Richard H.
育龄妇女癫痫的治疗仍然是一个临床挑战。虽然大多数女性癫痫患者需要抗惊厥药物来充分控制其癫痫发作，但与某些抗癫痫药物相关的致畸性是一种需要仔细解决的风险。抗癫痫药物也用于治疗范围不断扩大的医疗条件，如双相情感障碍，偏头痛预防，癌症和神经性疼痛。尽管大多数接受药物治疗的癫痫妇女的怀孕是正常的，但研究表明，与未经治疗的怀孕风险相比，怀孕并发重大先天畸形的风险增加了一倍。此外，当抗癫痫药物（AED）用于多药治疗方案时，风险增加两倍，特别是当包括丙戊酸（VPA）时。然而，应该注意的是，每种抗惊厥药物的风险都是特定的。一些研究表明，致畸性风险以剂量依赖性方式增加。最近的研究报告说，在子宫内暴露于AED可能会对生命后期的认知功能和语言技能产生不利影响。事实上，FDA刚刚发布了关于VPA对认知影响的安全公告（安全公告6-30-2011）。本文件的目的是审查最常用的化合物在治疗妇女癫痫，并提供最新的实验和人类流行病学研究的抗癫痫药物在暴露的胚胎的影响的信息。
The treatment of epilepsy in women of reproductive age remains a clinical challenge. While most women with epilepsy require anticonvulsant drugs for adequate control of their seizures, the teratogenicity associated with some antiepileptic drugs is a risk that needs to be carefully addressed. Antiepileptic medications are also used to treat an ever broadening range of medical conditions such as bipolar disorder, migraine prophylaxis, cancer and neuropathic pain. Despite the fact that the majority of pregnancies of women with epilepsy who are receiving pharmacological treatment are normal, studies have demonstrated that the risk of having a pregnancy complicated by a major congenital malformation is doubled when comparing the risk of untreated pregnancies. Furthermore, when antiepileptic drugs (AEDs) are used in polytherapy regimens, the risk is tripled, especially when valproic acid (VPA) is included. However, it should be noted that the risks are specific for each anticonvulsant drug. Some investigations have suggested that the risk of teratogenicity is increased in a dose-dependent manner. More recent studies have reported that in utero exposure to AEDs can have detrimental effects on the cognitive functions and language skills in later stages of life. In fact, the FDA just issued a safety announcement on the impact of VPA on cognition (Safety Announcement 6-30-2011). The purpose of this document is to review the most commonly used compounds in the treatment of women with epilepsy, and to provide information on the latest experimental and human epidemiological studies of the effects of antiepileptic drugs in the exposed embryos.
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影响因子：
3
作者：
Craig, J;Morrison, P;Patterson, V
通讯作者：
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作者：
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DOI：
10.1002/bdrb.20037
发表时间：
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影响因子：
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作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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作者：
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