妊娠中の抗痙攣薬は神経発達に影響する可能性(Antiseizure drugs during pregnancy may affect neurodevelopment)

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2024-11-15 カロリンスカ研究所(KI)

スウェーデンのカロリンスカ研究所の研究によると、妊娠中の抗てんかん薬の使用は子どもの神経発達に影響を与える可能性があることが示されました。特にバルプロ酸ナトリウムやトピラマートなどの薬剤を服用した場合、発達障害のリスクが上昇する一方、ラモトリギンはリスクが低いとされます。リスクは低いものの、薬の使用は医師と相談しながら慎重に進めることが推奨されています。

<関連情報>

妊娠中の抗痙攣薬の使用と子どもの神経発達結果 Antiseizure medication use during pregnancy and children’s neurodevelopmental outcomes

Paul Madley-Dowd,Viktor H. Ahlqvist,Harriet Forbes,Jessica E. Rast,Florence Z. Martin,Caichen Zhong,Ciarrah-Jane S. Barry,Daniel Berglind,Michael Lundberg,Kristen Lyall,Craig J. Newschaffer,Torbjörn Tomson,Neil M. Davies,Cecilia Magnusson,Dheeraj Rai & Brian K. Lee
Nature Communications  Published:15 November 2024
DOI:https://doi.org/10.1038/s41467-024-53813-1

妊娠中の抗痙攣薬は神経発達に影響する可能性(Antiseizure drugs during pregnancy may affect neurodevelopment)

Abstract

The teratogenic potential of valproate in pregnancy is well established; however, evidence regarding the long-term safety of other antiseizure medications (ASMs) during pregnancy remains limited. Using routinely collected primary care data from the UK and nationwide Swedish registries to create a cohort of 3,182,773 children, of which 17,495 were exposed to ASMs in pregnancy, we show that those exposed to valproate were more likely to receive a diagnosis of autism, intellectual disability, and ADHD, when compared to children not exposed to ASMs. Additionally, children exposed to topiramate were 2.5 times more likely to be diagnosed with intellectual disability (95% CI: 1.23–4.98), and those exposed to carbamazepine were 1.25 times more likely to be diagnosed with autism (95% CI: 1.05–1.48) and 1.30 times more likely to be diagnosed with intellectual disability (95% CI: 1.01–1.69). There was little evidence that children exposed to lamotrigine in pregnancy were more likely to receive neurodevelopmental diagnoses. While further research is needed, these findings may support considering safer treatment alternatives well before conception when clinically appropriate.

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