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Author Notes:

Corresponding author contact information: Anna M. Bank, MD, 45 Francis St, Boston, MA 02115, Phone: 617.732.7432, Fax: 888.217.1623, abank@partners.org.

The authors would like to thank Robert Glynn, PhD of Harvard Catalyst for his assistance with statistical analysis.

Dr. Anna M. Bank has no conflicts to disclose.

Dr. Zachary N. Stowe has participated in the speaker’s bureaus for GlaxoSmithKline, Pfizer, and Wyeth; served on the advisory boards for GlaxoSmithKline and Bristol Myers Squibb; has received research grant support from Pfizer, GlaxoSmithKline, Wyeth, and the National Institutes of Health, and clinical trials sponsored by Sage Therapeutics and Janssen Pharmaceuticals.

Dr. Newport has received research support from Eli Lilly, Glaxo SmithKline (GSK), Janssen, the National Alliance for Research on Schizophrenia and Depression (NARSAD), the National Institutes of Health (NIH), Takeda Pharmaceuticals, and Wyeth.

He has served on speakers’ bureaus and/or received honoraria from Astra-Zeneca, Eli Lilly, GSK, Pfizer and Wyeth.

He has served on advisory boards for GSK. He has never served as a consultant to any biomedical or pharmaceutical corporations.

Neither he nor family members have ever held equity positions in biomedical or pharmaceutical corporations.

Dr. James C. Ritchie has nothing to disclose.

Dr. Page B. Pennell has participated in the speaker’s bureau and advisory boards for GlaxoSmithKline and UCB Pharma and received research support from GSK, UCB Pharma, Marinus Pharmaceuticals, and the NIH at the time this data was gathered, and she continues to receive support from the NIH.

We confirm that we have read the Journal’s position on issues involved in ethical publication and affirm that this report is consistent with those guidelines.

Subjects:

Research Funding:

This work was supported by funds received from the National Institutes of Health, National Institute of Mental Health, award number P50 MH 68036 (Stowe, Newport, Pennell) and the National Institute of Neurological Disorders and Stroke and Eunice Kennedy Shriver National Institute of Child Health and Human Development, award number U01-NS038455 (Stowe, Pennell).

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Clinical Neurology
  • Neurosciences & Neurology
  • Epilepsy
  • Pregnancy
  • Placental passage
  • Antiepileptic drugs
  • Umbilical cord concentrations
  • LACTATION
  • EPILEPSY
  • SERUM

Placental passage of antiepileptic drugs at delivery and neonatal outcomes

Tools:

Journal Title:

Epilepsia

Volume:

Volume 58, Number 5

Publisher:

, Pages e82-e86

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Children of women treated with antiepileptic drugs (AEDs) are at increased risk of adverse outcomes detectable in the neonatal period, which may be associated with the amount of AEDs in the fetal circulation. Placental passage of AEDs can be measured by calculating the ratio of umbilical cord to maternal AED concentrations collected at delivery. The aims of this study were to determine the umbilical cord concentrations and umbilical-to-maternal ratios for AEDs, and whether higher cord concentrations are associated with increased risk of neonatal complications. AED cord and maternal blood concentrations from 70 mother–newborn dyads and neonatal complications were recorded. Logistic regressions were performed to determine the association between AED concentrations and complications. Mean umbilical-to-maternal ratios for total concentrations ranged from 0.79 for carbamazepine to 1.20 for valproic acid, and mean umbilical-to-maternal ratios for free concentrations ranged from 0.86 for valproic acid to 1.42 for carbamazepine, indicating complete placental passage. Neither umbilical cord concentrations nor umbilical-to-maternal ratios were associated with adverse neonatal outcomes. Additional investigations are warranted to delineate the relationship between quantified fetal AED exposure and neonatal complications.

Copyright information:

Wiley Periodicals, Inc. © 2017 International League Against Epilepsy

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