Risk of early neurodevelopmental outcomes associated with prenatal exposure to the antiepileptic drugs most commonly used during pregnancy: a French nationwide population-based cohort study
| Autor: | Joël Coste, Hugo Peyre, Yann Mikaeloff, Pierre Olivier Blotière, Rosemary Dray-Spira, Alain Weill, Zureik Mahmoud, Sara Miranda, Franck Ramus |
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| Přispěvatelé: | École nationale d'assurances (ENASS-CNAM), Conservatoire National des Arts et Métiers [CNAM] (CNAM), Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université de Lorraine (UL), Agence nationale de sécurité du médicament et des produits de santé [Saint-Denis] (ANSM), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse, Service de neurologie [Le Kremlin Bicêtre], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Université Paris sciences et lettres (PSL), Maladies neurodéveloppementales et neurovasculaires (NeuroDiderot (UMR_S_1141 / U1141)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Service psychiatrique de l'enfant et de l'adolescent [CHU Hôpital Robert Debré], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Robert Debré, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Centre d'Epidémiologie Clinique [AP-HP Hôpital Hôtel Dieu], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Hôtel Dieu, Laboratoire de sciences cognitives et psycholinguistique (LSCP), Département d'Etudes Cognitives - ENS Paris (DEC), École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-École des hautes études en sciences sociales (EHESS)-Centre National de la Recherche Scientifique (CNRS) |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Topiramate
Male Pediatrics medicine.medical_specialty Databases Factual paediatric neurology Population child & adolescent psychiatry Lamotrigine Cohort Studies 03 medical and health sciences 0302 clinical medicine Pregnancy medicine Humans 030212 general & internal medicine paediatric neurology epilepsy child & adolescent psychiatry Oxcarbazepine education Child education.field_of_study business.industry Valproic Acid [SDV.NEU.SC]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Cognitive Sciences General Medicine medicine.disease 3. Good health Neurology Child Development Disorders Pervasive Child Preschool Prenatal Exposure Delayed Effects Cohort epilepsy Anticonvulsants Female [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie Levetiracetam France business 030217 neurology & neurosurgery Cohort study medicine.drug |
| Zdroj: | BMJ Open BMJ Open, BMJ Publishing Group, 2020, 10 (6), pp.e034829. ⟨10.1136/bmjopen-2019-034829⟩ |
| ISSN: | 2044-6055 |
| Popis: | ObjectivesTo assess the association between prenatal exposure to monotherapy with the antiepileptic drugs (AEDs) most commonly used during pregnancy and the risk of various neurodevelopmental outcomes compared with lamotrigine.DesignNationwide population-based cohort study.SettingFrench national healthcare databases.ParticipantsChildren born alive between 2011 and 2014 and prenatally exposed to AED monotherapy.Primary and secondary outcome measuresOutcomes included neurodevelopmental disorders (NDD), defined by International Classification of Diseases, 10th Revision codes F70-F98—pervasive developmental disorders (PDD, F84) and mental retardation (MR, F70-F79) were studied separately—and visits to speech therapists. The reference group comprised children prenatally exposed to lamotrigine. Children were followed until outcome, loss to follow-up, death or 31 December 2016. We performed inverse probability of treatment weighting analyses using the propensity score, which included maternal and infant characteristics. Hazard ratios (HRs) were calculated using Cox models.ResultsThe cohort comprised 9034 children, 2916 of which were exposed to lamotrigine, 1627 to pregabalin, 1246 to clonazepam, 991 to valproic acid (VPA), 621 to levetiracetam, 502 to carbamazepine, 477 to topiramate, 378 to gabapentin and 143 to oxcarbazepine. None of these AEDs, except VPA, was associated with an increased risk of any of the four neurodevelopmental outcomes investigated. Exposure to VPA was associated with increased risks of NDDs (HR=2.7, 95% CI (1.8 to 4.0)), PDD (HR=4.4 (2.1 to 9.3)), MR (HR=3.1 (1.5 to 6.2)) and visits to speech therapists (HR=1.5 (1.1 to 1.9)), with a dose-response relationship.ConclusionsNo increased risk of any of the neurodevelopmental outcomes investigated in this study was observed with prenatal exposure to levetiracetam, pregabalin, oxcarbazepine, topiramate, gabapentin, clonazepam or carbamazepine, compared with lamotrigine. However, this study corroborates the well-known association between maternal use of VPA during pregnancy and the risk of neurodevelopmental disorders in the offspring. Longer follow-up is necessary to confirm these findings. |
| Databáze: | OpenAIRE |
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