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Gabapentin is not generally recommended in pregnancy as there is not enough information about whether it's safe for your baby. However, from the small amount of information that is available, there's no clear evidence that it's harmful. Background: Despite the widespread use, only sparse information is available on the safety of gabapentin during pregnancy. We sought to evaluate the association between gabapentin exposure during pregnancy and risk of adverse neonatal and maternal outcomes. Our results add to the current understanding of the safety of gabapentin prenatal use and provide pregnant women with pain conditions and epilepsy and their providers with important information, which can guide clinical decisions during pregnancy. Does taking gabapentin increase the chance of birth defects? Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. Small, controlled studies on gabapentin have not suggested an increased chance of birth defects. 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. Concerning exposure to gabapentin, increased risks of preterm birth, preeclampsia, small-for-gestational-age and NICU admission were reported in two studies. While the available information does not strongly suggest that it causes problems for the baby, further research is required to prove that gabapentin is safe. As a precaution, gabapentin is only prescribed in pregnancy when the benefits (most commonly of controlling seizures in women with epilepsy) outweigh the possible risks. This article summarizes the current literature regarding gabapentin use during pregnancy and related prenatal and neonatal exposure outcomes with special consideration for interactions between gabapentin and opioid use. Because of the increasing use of gabapentin in many settings of care and the limited information on its safety in pregnancy, there is a critical need for evidence to help pregnant women or women of childbearing age and their healthcare providers to balance the risks and benefits of gabapentin treatment with regard to pregnancy-related outcomes. The last decade has seen a significant increase in gabapentin prescriptions among pregnant people, particularly for off-label use, despite limited evidence of its safety during pregnancy. 6-8 Despite the lack of reports on the teratogenicity of gabapentin, it has been associated with the potential risk of congenital malformations, including Considering the increasing number of pregnant women who may be taking gabapentin for other conditions during pregnancy, such as restless legs syndrome, 7 and paucity of information regarding the safety of this medication in pregnancy, more information regarding fetal safety is required. 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. Most recently, a prospective study from researchers at the Motherisk program reports on the outcomes of 223 pregnancies exposed to gabapentin Advice and warnings for the use of Gabapentin during pregnancy. FDA Pregnancy Category C - Risk cannot be ruled out While the available information does not strongly suggest that it causes problems for the baby, further research is required to prove that gabapentin is safe. As a precaution, gabapentin is only prescribed in pregnancy when the benefits (most commonly of controlling seizures in women with epilepsy) outweigh the possible risks. 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 Due to mixed findings on its safety during pregnancy, gabapentin shouldn’t be taken during pregnancy without first discussing it with your doctor. Gabapentin (Neurontin) is an anti-seizure medication that’s also used for certain types of neuropathic pain. 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. Does taking gabapentin increase the chance of miscarriage? More research is required to define the pregnancy safety profile of gabapentin. Pregnant women and women of childbearing potential should be made aware of the lack of data for most pregnancy outcomes. Gabapentin should only be used during pregnancy where benefits of treatment are considered to outweigh any potential risks. In this study with over 4000 infants exposed to gabapentin, the information is reassuring. While we cannot rule out the possibility of a small increase in risk of cardiovascular malformations in gabapentin-exposed infants, gabapentin does not appear to be a major teratogen. 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.
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