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During pregnancy and after delivery, headaches can be signs of secondary disorders including preeclampsia, dural puncture, pituitary apoplexy, and infection. or early in pregnancy. Some There was a higher risk of preterm birth among women exposed to gabapentin either late (RR, 1.28 [1.08-1.52], p < 0.01) or both early and late in pregnancy (RR, 1.22 [1.09-1.36], p < 0.001), SGA In this large population-based study, we did not find evidence for an association between gabapentin exposure during early pregnancy and major malformations overall, although there was some evidence of a higher risk of cardiac malformations. Maternal use of gabapentin, particularly late in pregnancy gabapentin early in pregnancy appears to rule out large increases in risk, although available studies included small numbers of gabapentin-exposed pregnancies and therefore were not well powered to identify potential smaller teratogenic effects [4–11]. The American College of Obstetricians and Gynecologists (ACOG) has released guidelines on psychiatric medication used by women during pregnancy and lactation. The use of psychotropic medications All pregnant women in the UK will be offered a very detailed anomaly scan at around 20 weeks of pregnancy as part of their routine antenatal care. No extra monitoring for major birth defects is required following gabapentin use in pregnancy. Babies exposed to gabapentin before delivery may experience withdrawal symptoms for a few days after birth. Results from this large cohort study suggest that gabapentin exposure during early pregnancy does not appear to be associated with teratogenic effects, although a moderately higher risk of cardiac malformations—in particular, conotruncal defects—cannot be excluded. Advice and warnings for the use of Gabapentin during pregnancy. FDA Pregnancy Category C - Risk cannot be ruled out When treating neuropathic pain in a woman who is pregnant, the use of gabapentinoids (e.g. gabapentin) or an antiepileptic drug (AED) (e.g. levetiracetam, lamotrigine) is a last line option. This is due to the limited availability of data for safe use during pregnancy. Other options should be trialled first. There was a higher risk of preterm birth among women exposed to gabapentin either late (RR, 1.28 [1.08–1.52], p < 0.01) or both early and late in pregnancy (RR, 1.22 [1.09–1.36], p < 0.001), SGA among women exposed to gabapentin early (1.17 [1.02–1.33], p = 0.02), late (1.39 [1.01–1.91], p = 0.05), or both early and late in pregnancy There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to antiepileptic drugs (AEDs), such as gabapentin, during pregnancy. Encourage women who are taking gabapentin during pregnancy to enroll in the North American Antiepileptic Drug (NAAED) Pregnancy Registry by calling the toll free number 1-888-233-2334 or It is not known if gabapentin can make it harder to get pregnant. Sexual dysfunction (including loss of desire to have sex and loss of ability to have an orgasm) has been reported among women who take gabapentin. There was an increased risk of preterm birth among women exposed to gabapentin either late (RR=1.28 [CI 1.08-1.52], p < 0.01) or both early and late in pregnancy (RR=1.22 [1.09-1.36], p < 0.001). We have data on 223 pregnancy outcomes exposed to gabapentin and 223 unexposed pregnancies. The rates of major malformations were similar in both groups (p = 0.845). There was a higher rate of preterm births (p = 0.019) and low birth weight <2,500 g (p = 0.033) in the gabapentin group. Five studies reported significant findings with increased risks of overall congenital anomalies, specific anomalies (nervous system, eyes, oro-facial clefs, urinary and genital system), miscarriage, stillbirth and specific neurodevelopmental outcomes after exposure to pregabalin during pregnancy. One study looked at the pregnancy outcomes of people who received prescriptions for gabapentin. When looking at the outcomes of all the study participants, gabapentin exposure during early pregnancy does not appear to increase the chance of birth defects above the background risk. Selected References: Blotiere PO, et al. 2020. Risk of early neurodevelopmental outcomes associated with prenatal exposure to the antiepileptic drugs most commonly used during pregnancy: a French nationwide population-based cohort study. BMJ Open 10(6). Brannon GE, Rolland PD. Anorgasmia in a patient with bipolar disorder type 1 treated with gabapentin. J Clin Psychopharmacol. 2000;20(3):379 Pregnancy-related problems, such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth) have been reported in some studies looking at the use of gabapentin during pregnancy. There's no evidence to suggest that taking gabapentin reduces fertility in either men or women. However, discuss your pregnancy plans with a doctor. They may wish to review your medicine and prescribe a higher dose of folic acid for you to take (5mg a day) before you become pregnant. Early intervention and treatment of these patients may prevent progression to hyperemesis gravidarum, which, although rare, may require enteral or parenteral nutrition, a trial of psychiatric medications if the patient has psychiatric comorbidities, or corticosteroids or gabapentin in refractory cases .
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