We examined the association between gabapentin use during pregnancy and the prevalence of major congenital malformations, cardiac and orofacial malformations, and neonatal intensive care unit (NICU) admissions using multivariate regression models. Acetaminophen is considered the drug of choice for mild pain during pregnancy. NSAIDS can be used during the first and second trimester, but there are differences between agents in terms of risk category. Ibuprofen, diclofenac, ketorolac and celecoxib can be considered safer options in cases NSAIDS are indicated. Does taking gabapentin in pregnancy increase the chance of other pregnancy-related problems? 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. We examined the risk of major congenital malformations and cardiac defects associated with gabapentin exposure during the first trimester (T1), and the risk of preeclampsia (PE), preterm birth (PTB), small for gestational age (SGA), and neonatal intensive care unit admission (NICUa) associated with gabapentin exposure early, late, or both early With maternal doses up to 2.1 g/day, estimated doses for fully breastfed infants are 0.2 to 1.3 mg/kg/day (equivalent to 1.3 to 3.8% of the maternal weight-adjusted dose). An expert panel has deemed this drug is an acceptable choice for refractory restless leg syndrome during lactation. Gabapentin exposures from 5 pregnancy registries, 1 HG pilot study and 2 additional cases were reviewed. Among 294 first trimester gabapentin-monotherapy exposures, there were 5 major congenital malformations (MCMs) reported (1.7%), which favorably compares to the MCM rate in the general population (1.6–2.2%). Gabapentin/first trimester of pregnancy: 10 newborns (0.01%) [30] Patorno et al., 2020: Gabapentin/first trimester of pregnancy: 4642 pregnancies (0.26%) Patorno et al., 2020: Gabapentin/early in pregnancy (first 140 days of pregnancy and no gabapentin dispensing from the 141 and 245 days)3745 pregnancies (0.21%) Patorno et al., 2020 While gabapentin (Neurontin) is now used in a wide variety of clinical settings — for epilepsy, pain management, restless leg syndrome, anxiety, and sleep disturbance – there is relatively little information regarding its reproductive safety. We examined the risk of major congenital malformations and cardiac defects associated with gabapentin exposure during the first trimester (T1), and the risk of preeclampsia (PE), preterm birth (PTB), small for gestational age (SGA), and neonatal intensive care unit admission (NICUa) associated with gabapentin exposure early, late, or both early A prospective study from researchers at the Motherisk program reports on the outcomes of 223 pregnancies exposed to gabapentin and 223 unexposed pregnancies. Despite the fact that gabapentin (Neurontin) is now used in a wide variety of clinical settings -- for epilepsy, pain management, anxiety, sleep disturbance – there is relatively little We examined the risk of major congenital malformations and cardiac defects associated with gabapentin exposure during the first trimester (T1), and the risk of preeclampsia (PE), preterm birth 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). first trimester (T1) of pregnancy and major malformations overall, although there was some evidence of a higher risk of cardiac malformations. There was a higher risk of pre-term birth, small for gestational age (SGA), and neonatal intensive care unit admission (NICUa) among women exposed to gabapentin, particularly in late pregnancy. 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. 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. We examined the risk of major congenital malformations and cardiac defects associated with gabapentin exposure during the first trimester (T1), and the risk of preeclampsia (PE), preterm birth (PTB), small for gestational age (SGA), and neonatal intensive care unit admission (NICUa) associated with gabapentin exposure early, late, or both early Antiprostaglandins, such as aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs), are typically contraindicated throughout pregnancy, and if they are used at all, it should only be in the first and second trimester, as these medications hold the risk of causing premature closure of the ductus arteriosus in the fetus if administrated at Gabapentin (Neurontin®) is mainly used to treat epilepsy and nerve pain, and to prevent migraine. What are the benefits of taking gabapentin in pregnancy? Gabapentin prevents epileptic seizures, which can be dangerous to the woman and also lead to pregnancy complications. In our study, only 28% of the women continued taking gabapentin throughout pregnancy as two-thirds of the women (66%) discontinued in the first trimester, most following pregnancy confirmation between 6 and 8 weeks’ gestation. Our objectives were to 1) determine whether first-trimester use of gabapentin is associated with an increased risk for major malformations; 2) examine rates of spontaneous abortions, therapeutic abortions, stillbirths, mean birth weight and gestational age at delivery; and 3) examine rates of poor neonatal adaptation syndrome following late pregnancy exposure.
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