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dc.contributor.author
Tomson, Torbjörn
dc.contributor.author
Battino, Dina
dc.contributor.author
Thomas, Sanjeev V.
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Vajda, Frank
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Kochen, Sara Silvia
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Craig, John
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Binozzoni, Erminio
dc.contributor.author
Lindhout, Dick
dc.contributor.author
Perucca, Emilio
dc.contributor.author
Sabers, Anne
dc.date.available
2021-01-04T21:13:39Z
dc.date.issued
2019-08
dc.identifier.citation
Tomson, Torbjörn; Battino, Dina; Thomas, Sanjeev V.; Vajda, Frank; Kochen, Sara Silvia; et al.; Declining malformation rates with changed antiepileptic drug prescribing: An observational study; NLM (Medline); Neurology; 93; 9; 8-2019; 831-840
dc.identifier.uri
http://hdl.handle.net/11336/121432
dc.description.abstract
Objective Changes in prescribing patterns of antiepileptic drugs (AEDs) in pregnant women with epilepsy would be expected to affect the risk of major congenital malformations (MCMs). To test this hypothesis, we analyzed data from an international pregnancy registry (EURAP). Methods EURAP is an observational prospective cohort study designed to determine the risk of MCMs after prenatal exposure to AEDs. The Cochrane-Armitage linear trend analysis was used to assess changes in AED treatment, prevalence of MCMs, and occurrence of generalized tonic-clonic seizures (GTCs) over 3 time periods: 2000–2005 (n = 4,760), 2006–2009 (n = 3,599), and 2010–2013 (n = 2,949). Results There were pronounced changes in the use of specific AEDs over time, with a decrease in the use of valproic acid and carbamazepine and an increase in the use of lamotrigine and levetiracetam. The prevalence of MCMs with monotherapy exposure decreased from 6.0% in 2000–2005 to 4.4% in 2010–2013. The change over time in MCM frequency after monotherapy exposure showed a significant linear trend in the crude analysis (p = 0.0087), which was no longer present after adjustment for changes in AED treatment (p = 0.9923). There was no indication of an increase over time in occurrence of GTCs during pregnancy. Conclusions There have been major changes in AED prescription patterns over the years covered by the study. In parallel, we observed a significant 27% decrease in the prevalence of MCMs. The results of adjusting the trend analysis for MCMs for changes in AED treatment suggest that changes in prescription patterns played a major role in the reduction of teratogenic events.
dc.format
application/pdf
dc.language.iso
eng
dc.publisher
NLM (Medline)
dc.rights
info:eu-repo/semantics/openAccess
dc.rights.uri
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.subject
Epilepsia
dc.subject
Neurologia
dc.subject.classification
Neurología Clínica
dc.subject.classification
Medicina Clínica
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CIENCIAS MÉDICAS Y DE LA SALUD
dc.title
Declining malformation rates with changed antiepileptic drug prescribing: An observational study
dc.type
info:eu-repo/semantics/article
dc.type
info:ar-repo/semantics/artículo
dc.type
info:eu-repo/semantics/publishedVersion
dc.date.updated
2020-11-19T21:57:09Z
dc.identifier.eissn
1526-632X
dc.journal.volume
93
dc.journal.number
9
dc.journal.pagination
831-840
dc.journal.pais
Estados Unidos
dc.description.fil
Fil: Tomson, Torbjörn. Karolinska Huddinge Hospital. Karolinska Institutet; Suecia
dc.description.fil
Fil: Battino, Dina. Karolinska Huddinge Hospital. Karolinska Institutet; Suecia
dc.description.fil
Fil: Thomas, Sanjeev V.. Karolinska Huddinge Hospital. Karolinska Institutet; Suecia
dc.description.fil
Fil: Vajda, Frank. Karolinska Huddinge Hospital. Karolinska Institutet; Suecia
dc.description.fil
Fil: Kochen, Sara Silvia. Provincia de Buenos Aires. Ministerio de Salud. Hospital Alta Complejidad en Red El Cruce Dr. Néstor Carlos Kirchner Samic; Argentina. Universidad Nacional Arturo Jauretche. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos. Provincia de Buenos Aires. Ministerio de Salud. Hospital Alta Complejidad en Red El Cruce Dr. Néstor Carlos Kirchner Samic. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos; Argentina
dc.description.fil
Fil: Craig, John. Karolinska Huddinge Hospital. Karolinska Institutet; Suecia
dc.description.fil
Fil: Binozzoni, Erminio. Karolinska Huddinge Hospital. Karolinska Institutet; Suecia
dc.description.fil
Fil: Lindhout, Dick. Karolinska Huddinge Hospital. Karolinska Institutet; Suecia
dc.description.fil
Fil: Perucca, Emilio. Karolinska Huddinge Hospital. Karolinska Institutet; Suecia
dc.description.fil
Fil: Sabers, Anne. Karolinska Huddinge Hospital. Karolinska Institutet; Suecia
dc.journal.title
Neurology
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/doi/http://dx.doi.org/10.1212/WNL.0000000000008001
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/url/https://n.neurology.org/content/93/9/e831.long
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