Topiramate, Zonisamide and Small for Gestational Age: Maternal Factors, Timing of Exposure and Baby Fat
Year: 2014
Type: article
Abstract: Small for gestational age (SGA) is commonly defined as weight below the 10 th percentile for gestational age (1).The concern regarding SGA is its implications for development; it is associated with an increased risk for neonatal distress, permanent deficits in growth and neurocognitive development, and mortality.However, SGA babies are a heterogeneous group, and approximately 50% are constitutionally small, due to maternal ethnicity, body habitus, and body mass index (BMI) and these infants will develop normally (2).In 2005, 10% of births to Hispanic, American Indian/Alaska Native, and non-Hispanic white women in the United States met the criteria for SGA, and the occurrence in non-Hispanic Black births was 17% (1).Topiramate is associated with an increased risk of major congenital malformations (MCMs), with 1.4 % of births showing facial clefts, recently described by this group (3, 4) and others (5).These rare cases were excluded from the analysis herein.Within the North American Antiepileptic Drug Pregnancy Registry (NAAEDPR), a structurally related drug, zonisamide has been associated with a low risk of MCMs, with none occurring in 90 monotherapy exposures, therefore the upper limit of the 95% confidence interval (CI) is 3.3% (3).The authors adjusted for many factors that could contribute to small for gestational age, including smoking, maternal illness, and socioeconomic indicators.The overwhelming majority of mothers were Caucasian (> 85%) which minimizes the ethnic variability that could result in some SGA babies.This was also very highly educated cohort.Having at least 2 years of college education was reported in 45% of the topiramatetreated mothers, and this was the least educated group.
Author: Cynthia L. Harden
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2029568444