{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T12:10:16Z","timestamp":1789992616769,"version":"4.0.1"},"reference-count":18,"publisher":"FapUNIFESP (SciELO)","issue":"8","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Assoc. Med. Bras."],"abstract":"<jats:p>SUMMARY  OBJECTIVE: Antiseizure medications used during pregnancy may exert teratogenic effects on the developing fetus, with risks varying according to drug type, dosage, and exposure timing. While older agents such as carbamazepine are associated with known risks, newer agents including lamotrigine and levetiracetam have demonstrated more favorable safety profiles. This study aimed to evaluate pregnancy outcomes, major congenital malformation rates, and seizure frequency in pregnant women with epilepsy exposed to carbamazepine, lamotrigine, or levetiracetam as monotherapy or polytherapy, compared with an untreated control group.  METHODS: This retrospective observational study included pregnant women with epilepsy who were categorized into antiseizure medication-exposed (monotherapy or polytherapy) and non-exposed groups. Clinical data, including seizure history, medication type and dosage, pregnancy outcomes, and neonatal findings, were collected. major congenital malformations were identified according to European Surveillance of Congenital Anomalies criteria.  RESULTS: A total of 307 pregnancies were analyzed, resulting in 276 live births. major congenital malformation rates were 6.1% for carbamazepine, 1.7% for levetiracetam, and 3.6% for lamotrigine monotherapy. Polytherapy outcomes varied by combination, with relatively low risks observed in levetiracetam-containing regimens. Seizure frequency remained unchanged in most cases (69.6%), increased in 21%, and decreased in 9.4% of pregnancies. Preconception seizure presence significantly increased the risk of seizures during pregnancy.  CONCLUSION: Levetiracetam and lamotrigine demonstrate favorable safety profiles, whereas carbamazepine carries a moderate teratogenic risk. Polytherapy risk is combination-dependent, and preconception seizure control is a key predictor of seizure outcomes during pregnancy.<\/jats:p>","DOI":"10.1590\/1806-9282.20260587","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T11:29:40Z","timestamp":1789990180000},"source":"Crossref","is-referenced-by-count":0,"title":["Teratogenic risk of carbamazepine, levetiracetam, and lamotrigine treatment in pregnant women with epilepsy"],"prefix":"10.1590","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2477-5244","authenticated-orcid":false,"given":"Guray","family":"Koc","sequence":"first","affiliation":[{"name":"University of Health Sciences,  T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0544-524X","authenticated-orcid":false,"given":"Zeki","family":"Gokcil","sequence":"additional","affiliation":[{"name":"University of Health Sciences,  T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2026]]},"reference":[{"issue":"8","key":"ref1","doi-asserted-by":"crossref","first-page":"1765","DOI":"10.1111\/epi.16953","article-title":"Neurodevelopmental outcomes in children exposed to newer antiseizure medications: a systematic review","volume":"62","author":"Knight R","year":"2021","journal-title":"Epilepsia"},{"issue":"3","key":"ref2","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1007\/s13760-018-0996-7","article-title":"Fetal safety of levetiracetam use during pregnancy","volume":"118","author":"Koc G","year":"2018","journal-title":"Acta Neurol Belg"},{"issue":"4","key":"ref3","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1212\/WNL.0b013e31827f0874","article-title":"Levetiracetam in pregnancy: results from the UK and Ireland epilepsy and pregnancy registers","volume":"80","author":"Mawhinney 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PE","year":"2022","journal-title":"Neurology"},{"issue":"8","key":"ref7","article-title":"Monotherapy treatment of epilepsy in pregnancy: congenital malformation outcomes in the child","volume":"8","author":"Bromley R","year":"2023","journal-title":"Cochrane Database Syst Rev"},{"issue":"5","key":"ref8","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1001\/jamaneurol.2024.0258","article-title":"Risk of major congenital malformations and exposure to antiseizure medication monotherapy","volume":"81","author":"Battino D","year":"2024","journal-title":"JAMA Neurol"},{"issue":"6","key":"ref9","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1016\/S1474-4422(18)30107-8","article-title":"Comparative risk of major congenital malformations with eight different antiepileptic drugs: a prospective cohort study of the EURAP registry","volume":"17","author":"Tomson T","year":"2018","journal-title":"Lancet Neurol"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"17562864221101687","DOI":"10.1177\/17562864221101687","article-title":"Treatment and care of women with epilepsy before, during, and after pregnancy: a practical guide","volume":"15","author":"Nucera B","year":"2022","journal-title":"Ther Adv Neurol Disord"},{"issue":"2","key":"ref11","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1212\/CON.0000000000001104","article-title":"Update on antiseizure medications 2022","volume":"28","author":"Abou-Khalil BW","year":"2022","journal-title":"Continuum (Minneap Minn)"},{"issue":"11","key":"ref12","article-title":"Teratogenesis, perinatal, and neurodevelopmental outcomes after in utero exposure to antiseizure medication: practice guideline from the AAN, AES, and SMFM","volume":"102","author":"Pack AM","year":"2024","journal-title":"Neurology"},{"issue":"4","key":"ref13","doi-asserted-by":"crossref","first-page":"1639","DOI":"10.1002\/epi.70067","article-title":"Fetal outcomes of antiseizure medication use during pregnancy: a nationwide retrospective cohort study","volume":"67","author":"Seo M","year":"2026","journal-title":"Epilepsia"},{"issue":"2","key":"ref14","doi-asserted-by":"crossref","DOI":"10.1212\/WNL.0000000000207996","article-title":"Comparative risk of major congenital malformations with antiseizure medication combinations vs valproate monotherapy in pregnancy","volume":"102","author":"Cohen JM","year":"2024","journal-title":"Neurology"},{"issue":"16","key":"ref15","doi-asserted-by":"crossref","first-page":"2682","DOI":"10.1080\/14767058.2019.1670806","article-title":"An analysis of the high cesarean section rates in Turkey by Robson classification","volume":"34","author":"Eyi EGY","year":"2021","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"6","key":"ref16","doi-asserted-by":"crossref","first-page":"1899","DOI":"10.1111\/epi.18335","article-title":"Assisted reproduction and the fetal malformation risk associated with antiseizure medication exposure in pregnancy","volume":"66","author":"Vajda F","year":"2025","journal-title":"Epilepsia"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"109256","DOI":"10.1016\/j.yebeh.2023.109256","article-title":"Changes in seizure frequency and anti-seizure medication therapy during pregnancy and one year postpregnancy","volume":"144","author":"Du Y","year":"2023","journal-title":"Epilepsy Behav"},{"issue":"26","key":"ref18","doi-asserted-by":"crossref","first-page":"2547","DOI":"10.1056\/NEJMoa2008663","article-title":"Changes in seizure frequency and antiepileptic therapy during pregnancy","volume":"383","author":"Pennell PB","year":"2020","journal-title":"N Engl J Med"}],"container-title":["Revista da Associa\u00e7\u00e3o M\u00e9dica 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