{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T12:54:11Z","timestamp":1782132851911,"version":"3.54.5"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100007543","name":"Agence Nationale de S\u00e9curit\u00e9 du M\u00e9dicament et des Produits de Sant\u00e9","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007543","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020992","name":"Caisse nationale de l'Assurance Maladie","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100020992","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim of this study was to assess the impact of introducing a pregnancy pictogram on medication packaging on the prescription and dispensation of antiseizure medications and on the maternal and neonatal outcomes for women exposed to these medications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a national retrospective cohort study, based on the French National Health Data System, with a \u201cbefore\/after the introduction of the pictogram\u201d design. Women aged between 15 and 55\u2009years who had a pregnancy outcome between 2014 and 2017 (\u201cbefore pictogram\u201d period) and between 2018 and 2021 (\u201cafter pictogram\u201d period) and who had received at least two antiseizure medication dispensations before their pregnancy were included. We compared the rates of antiseizure medication discontinuation and continuation during pregnancy, the average doses used, and maternal and neonatal outcomes between the two periods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The rate of women who had received at least two dispensations of a medication indicated for epilepsy before their pregnancy remained stable between the two periods (.7%). There was a significant decrease in valproic acid prescriptions (5.4% vs. 1.3%) during pregnancy and, conversely, an increase in lamotrigine (29.9% vs. 31.5%) and levetiracetam (10.9% vs. 14.5%) prescriptions. Prescriptions by specialists such as neurologists increased significantly (22.8% vs. 28%) between the two periods. There was an increase of more than 2.7% in the continuation of antiseizure medication (37.6% vs. 40.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.0001) and conversely a decrease in the rate of women who stopped their antiseizure treatment before or during pregnancy in the \u201cafter pictogram\u201d period (59.4% vs. 56.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.0001). Rates of maternal and neonatal outcomes remained similar between the two periods.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>The introduction of a pregnancy pictogram in France in 2017 was not associated with an increase in discontinuation of antiseizure medications, less adequate treatment, or poorer maternal or neonatal outcomes in pregnant women receiving these medications before pregnancy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi.70163","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T05:40:16Z","timestamp":1773121216000},"page":"2864-2874","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Did the French pregnancy pictogram change antiseizure medication use during pregnancy?"],"prefix":"10.1002","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3057-9554","authenticated-orcid":false,"given":"M\u00e9lanie","family":"Araujo","sequence":"first","affiliation":[{"name":"Facult\u00e9 de M\u00e9decine de Toulouse Centre Hospitalier Universitaire de Toulouse, Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale (INSERM) Unit\u00e9 Mixte de Recherche (UMR) 1295  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5018-0108","authenticated-orcid":false,"given":"Christine","family":"Damase\u2010Michel","sequence":"additional","affiliation":[{"name":"Facult\u00e9 de M\u00e9decine de Toulouse Centre Hospitalier Universitaire de Toulouse, Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale (INSERM) Unit\u00e9 Mixte de Recherche (UMR) 1295  Toulouse 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Universitaire de Toulouse, Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale (INSERM) Unit\u00e9 Mixte de Recherche (UMR) 1295  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1213-5693","authenticated-orcid":false,"given":"Monica","family":"Saucedo","sequence":"additional","affiliation":[{"name":"Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale (INSERM), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Center for Research in Epidemiology and Statistics, Obstetrical Perinatal and Pediatric Life Course Epidemiology Universit\u00e9 Paris Cit\u00e9, Universit\u00e9 Paris Nord  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6561-3321","authenticated-orcid":false,"given":"Catherine","family":"Deneux\u2010Tharaux","sequence":"additional","affiliation":[{"name":"Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale (INSERM), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Center for Research in Epidemiology and Statistics, Obstetrical Perinatal and Pediatric Life Course Epidemiology Universit\u00e9 Paris Cit\u00e9, Universit\u00e9 Paris Nord  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7344-7282","authenticated-orcid":false,"given":"Isabelle","family":"Lacroix","sequence":"additional","affiliation":[{"name":"Facult\u00e9 de M\u00e9decine de Toulouse Centre Hospitalier Universitaire de Toulouse, Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale (INSERM) Unit\u00e9 Mixte de Recherche (UMR) 1295  Toulouse 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