4.6 Review

Exposure to medication for neurological disease in pregnancy - time to consider the long-term implications?

期刊

ECLINICALMEDICINE
卷 63, 期 -, 页码 -

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ELSEVIER
DOI: 10.1016/j.eclinm.2023.102157

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Pregnancy; Epilepsy; Neuroinflammation; Long term outcomes; Neurodevelopment; Immunity

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This article examines the long-term effects of treatments used for common long-term neurological conditions diagnosed in early adulthood, and discusses strategies to improve future knowledge.
A range of long-term neurological conditions may be diagnosed in young adulthood. These conditions are generally not curable, and most people need to take ongoing treatment for symptom control and/or disease modification. When chronic diseases are diagnosed before people have completed their families, there is a need to balance the potential benefits of treatment for the mother against potential risk(s) to the fetus from exposure to medications during pregnancy. Whilst available data regarding short-term fetal outcomes following treatment exposures during pregnancy is rapidly increasing, information regarding longer-term outcomes is more limited. The association of fetal exposure to valproate with serious long-term neurodevelopmental outcomes has highlighted the importance of capturing and evaluating long-term data.In this review we examine available evidence around the long-term effects of treatments used for the most common long-term neurological conditions diagnosed in early adulthood, namely epilepsy, migraine and neuroinflammatory disorders. We draw from existing literature across a range of diseases and discuss strategies to improve future knowledge.

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