Antiepileptic drugs during pregnancy in primary care: a UK population based study.

<h4>Objective</h4>Antiepileptic drugs (AEDs) are commonly prescribed for epilepsy and bipolar disorder but little is known about their use in pregnancy. We examined secular trends in AED prescribing in pregnancy and pregnancy as a determinant for stopping AED prescribing.<h4>Method...

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Autores principales:	Shuk-Li Man, Irene Petersen, Mary Thompson, Irwin Nazareth
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/29cc8225a9cf4de49c80d77e99dc19fe
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spelling	oai:doaj.org-article:29cc8225a9cf4de49c80d77e99dc19fe2021-11-18T08:04:37ZAntiepileptic drugs during pregnancy in primary care: a UK population based study.1932-620310.1371/journal.pone.0052339https://doaj.org/article/29cc8225a9cf4de49c80d77e99dc19fe2012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23272239/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objective</h4>Antiepileptic drugs (AEDs) are commonly prescribed for epilepsy and bipolar disorder but little is known about their use in pregnancy. We examined secular trends in AED prescribing in pregnancy and pregnancy as a determinant for stopping AED prescribing.<h4>Methods</h4>We identified 174,055 pregnancies from The Health Improvement Network UK primary care database. Secular trends in AED prescribing during pregnancy were examined between 1994 and 2009. We used Cox's regression analyses to compare time to discontinuation of AED prescriptions between pregnant and non-pregnant women and to identify predictors of discontinuation of AEDs in pregnancy.<h4>Results</h4>Prescribing of carbamazepine and sodium valproate have declined since 1994 despite being the most commonly prescribed AEDs in pregnancy up to 2004. Prescribing of lamotrigine in pregnancy has steadily increased and has been the most popular AED prescribed in pregnancy since 2004. Pregnant women with epilepsy were twice as likely to stop receiving AEDs (Hazard Ratio (HR) 2.00, 95% Confidence Interval (CI) 1.62-2.47) when compared to non-pregnant women and for women with bipolar disorder this was even higher (HR 3.07, 95% CI 2.04-4.62). For pregnant women with epilepsy, those receiving AEDs less regularly before pregnancy were more likely to stop receiving AEDs in pregnancy.<h4>Conclusions</h4>Lamotrigine has been increasingly prescribed in pregnancy over older AEDs namely carbamazepine and sodium valproate. Pregnancy is a strong determinant for the discontinuation of AED prescribing particularly for women with bipolar disorder.Shuk-Li ManIrene PetersenMary ThompsonIrwin NazarethPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 12, p e52339 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Shuk-Li Man Irene Petersen Mary Thompson Irwin Nazareth Antiepileptic drugs during pregnancy in primary care: a UK population based study.
description	<h4>Objective</h4>Antiepileptic drugs (AEDs) are commonly prescribed for epilepsy and bipolar disorder but little is known about their use in pregnancy. We examined secular trends in AED prescribing in pregnancy and pregnancy as a determinant for stopping AED prescribing.<h4>Methods</h4>We identified 174,055 pregnancies from The Health Improvement Network UK primary care database. Secular trends in AED prescribing during pregnancy were examined between 1994 and 2009. We used Cox's regression analyses to compare time to discontinuation of AED prescriptions between pregnant and non-pregnant women and to identify predictors of discontinuation of AEDs in pregnancy.<h4>Results</h4>Prescribing of carbamazepine and sodium valproate have declined since 1994 despite being the most commonly prescribed AEDs in pregnancy up to 2004. Prescribing of lamotrigine in pregnancy has steadily increased and has been the most popular AED prescribed in pregnancy since 2004. Pregnant women with epilepsy were twice as likely to stop receiving AEDs (Hazard Ratio (HR) 2.00, 95% Confidence Interval (CI) 1.62-2.47) when compared to non-pregnant women and for women with bipolar disorder this was even higher (HR 3.07, 95% CI 2.04-4.62). For pregnant women with epilepsy, those receiving AEDs less regularly before pregnancy were more likely to stop receiving AEDs in pregnancy.<h4>Conclusions</h4>Lamotrigine has been increasingly prescribed in pregnancy over older AEDs namely carbamazepine and sodium valproate. Pregnancy is a strong determinant for the discontinuation of AED prescribing particularly for women with bipolar disorder.
format	article
author	Shuk-Li Man Irene Petersen Mary Thompson Irwin Nazareth
author_facet	Shuk-Li Man Irene Petersen Mary Thompson Irwin Nazareth
author_sort	Shuk-Li Man
title	Antiepileptic drugs during pregnancy in primary care: a UK population based study.
title_short	Antiepileptic drugs during pregnancy in primary care: a UK population based study.
title_full	Antiepileptic drugs during pregnancy in primary care: a UK population based study.
title_fullStr	Antiepileptic drugs during pregnancy in primary care: a UK population based study.
title_full_unstemmed	Antiepileptic drugs during pregnancy in primary care: a UK population based study.
title_sort	antiepileptic drugs during pregnancy in primary care: a uk population based study.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/29cc8225a9cf4de49c80d77e99dc19fe
work_keys_str_mv	AT shukliman antiepilepticdrugsduringpregnancyinprimarycareaukpopulationbasedstudy AT irenepetersen antiepilepticdrugsduringpregnancyinprimarycareaukpopulationbasedstudy AT marythompson antiepilepticdrugsduringpregnancyinprimarycareaukpopulationbasedstudy AT irwinnazareth antiepilepticdrugsduringpregnancyinprimarycareaukpopulationbasedstudy
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Antiepileptic drugs during pregnancy in primary care: a UK population based study.

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