Fetal growth, major XXXX , and @entity154 in @entity1 born to @entity1 receiving @entity1092 .

@entity1 @entity154 @entity2122 @entity1092 @entity147 @entity600 @entity2052 @entity302
The association of fetal and neonatal distress, birth measurements, major @entity600 , and @entity154 was studied prospectively in 14 @entity1 of @entity1 with @entity302 who were receiving @entity1092 ( @entity2052 ) monotherapy and in 12 @entity1 of @entity1 with @entity302 who were receiving @entity2052 in combination with other anticonvulsant drugs. Comparison was made with 26 matched-pair controls and 116 controls from a larger study of antiepileptic drugs. During the first trimester, total @entity2052 serum concentrations were well above therapeutic levels (100 to 184 micrograms/ml) in two @entity1 receiving high @entity2052 doses (2000 and 1500 mg daily). Although dosage remained the same, serum concentrations decreased during pregnancy to therapeutic levels (33.9 to 57.0 micrograms/ml). The @entity2052 percent free fraction increased in the third trimester and was threefold higher at birth. Almost half of the @entity1 exposed to @entity2052 monotherapy were distressed during labor, and 28% had low Apgar scores. @entity147 may be caused by the high @entity2052 percent free fraction during labor and at birth. Mean body measurements at birth after @entity2052 monotherapy were comparable to those in the matched control group, but were reduced in the group of @entity1 receiving @entity2052 combination therapy. Four @entity1 exposed to @entity2052 monotherapy were born with major @entity600 . The median number of @entity154 was four times higher in @entity1 whose mothers received @entity2052 alone or @entity2052 combination therapy than in controls. Seven @entity1 had a pattern of @entity2122 that was distinctly different from that observed after in utero exposure to other anticonvulsant medications. The occurrence of major @entity600 and the number of @entity154 may be dose related.
