Maternal and Umbilical Cord Plasma Concentrations of Antiseizure Medications: Results from the MONEAD Study
Abstract number :
3.289
Submission category :
7. Anti-seizure Medications / 7C. Cohort Studies
Year :
2021
Submission ID :
1826468
Source :
www.aesnet.org
Presentation date :
12/6/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:54 AM
Authors :
Charul Avachat, MS - University of Minnesota, Twin cities; Evan Gedzelman – Emory University , School of medicine; Abigail Mathews – Emmes Corporation; Thomas McElrath – Brigham and Women's Hospital, Harvard Medical School; Angela Birnbaum – Experimental and Clinical Pharmacology – University of Minnesota; Elizabeth Gerard – Neurology – Northwestern University; Laura Kalayjian – University of Southern California; Kimford Meador – Neurology & Neurological Sciences – Stanford University; Page Pennell – Neurology – Brigham and Women's Hospital, Harvard Medical School; Patricia Penovich – Minnesota Epilepsy Group
Rationale: Antiseizure medication (ASM) concentrations change throughout pregnancy. Unanticipated ASM exposure can lead to subtherapeutic or toxic medication concentrations in the mother and unnecessary drug exposure to the fetus. Data from small studies report the presence of ASMs in cord blood. The objectives of this study were to characterize ASM concentrations in mother's and cord blood at delivery in women with epilepsy (PWWE) who were enrolled in the 20-site Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD) study.
Methods: The analysis included PWWE (ages 14-45 years) who were on ASM monotherapy or polytherapy during the birth visit. Women with an IQ < 70, major medical illness, substance use and poor treatment adherence were excluded. Seizures, ASM dosing, and adherence were tracked via an electronic app with dosing being verified at each study visit. Blood samples were collected at 3-4 time points during pregnancy and over 9 months postpartum. The ratio of umbilical cord to maternal plasma concentration was used as a measure of fetal in-utero exposure. Pearson correlation coefficients were calculated to determine the degree of correlation between ASM maternal and cord plasma concentrations. A p-value of p< 0.05 was deemed to be statistically significant.
Anti-seizure Medications