progress, but persistent risks

A national study conducted by Epi-Phare, published in the review NeurologyAnalysis of the evolution of prenatal exposure to antiepileptic drugs (MAES) in France between 2013 and 2021. Similarly, Thanks to the data from the Mother-Epi-Meres national register. Nevertheless, this study highlights contrasting trends, highlighting notable progress, but also concerns for disadvantaged populations.

Valproate in decline. For example, other risks present – Progress, but persistent risks

One of the main lessons in the study is the drastic fall in exposure to valproic acid and valpride, two antiepileptics known for their high risk of malformations and neurodevelopmental disorders. Consequently, Between 2013 and 2021, the pregnancies exposed to valproic acid decreased by 84 %, and those in the valpride of – 89 %. This decrease is accompanied by a reduction in the number of pregnancies that have been the subject of several valproate issues. a drop in prolonged exposure throughout pregnancy.

Despite this progress. progress, but persistent risks exposure to other recognized risky antiepileptics (carbamazepine, topiramate) remains worrying, with nearly 600 newborns exhibited each year during the period 2019-2021.

A persistent exposure to MAES at uncertain risks – Progress, but persistent risks

The use of drugs at uncertain risks such as pregabalin. gabapentine or more recent molecules (lacosamide, zonisamide) has increased sharply. Pregabalin thus experiences an increase of + 171 % prolonged exposure during pregnancy.

Increase in the use of antiepileptics at lower risk

At the same time. antiepileptics deemed less risky, such as lamotrigine and levetiracetam, have seen their use increase by + 30 %. This sliding towards safer alternatives is a better consideration of treatment safety profiles, both by health professionals and by patients.

Social inequalities marked in the exhibition

The study also reveals an over -representation of low -income pregnant women among the pregnancies exposed to MAES at high. uncertain risks: 18.5 % against 13 % for the less risky. This observation highlights progress, but persistent risks an inequality of access to information and safe therapeutic alternatives, posing a major public health issue.

Strengthen prevention. support

If the decrease in the use of valproate shows the effectiveness of prevention policies, the development of new MAES with uncertain profiles requires reinforced vigilance. The study calls for new risk minimization measures. with targeted support for the most vulnerable women, in order to guarantee the safety of pregnancies exposed to these treatments.