Abstract
Introduction
Experience about the use and safety of anti-Parkinson (anti-PD) medication during pregnancy is scarce.
Methods
We have retrospectively evaluated the course and outcome of pregnancy in PD patients who used anti-PD medication during their pregnancy.
Results
14 PD patients who used anti-PD medication during part or whole of their pregnancy were included. Dopamine agonists were used in 13 patients, levodopa/benserazide in 4, levodopa/carbidopa/entacapone in 1, rasagiline in 7, amantadine in 4, and biperiden in 1 patient. Nine patients were on combination treatment at the time of their pregnancy. During their whole pregnancy, dopamine agonists had been used in six patients, levodopa in four, and rasagiline in one. Four patients experienced adverse outcomes: one had spontaneous abortion while receiving pramipexole, one elderly mother gave birth to a child with Down syndrome, while receiving pramipexole and rasagiline, in one case, there was fetal distress under levodopa/benserazide, piribedil, and rasagiline which resolved spontaneously, in one case, one of the twins did not survive after the birth while the mother was receiving pramipexole and rasagiline. In none of these cases an association with the use of anti-PD medication and adverse outcomes was clearly established. In one patient, motor symptoms worsened despite high dose levodopa, four others experienced transient worsening upon dose reduction.
Conclusion
Results in our case series suggest that levodopa, rasagiline, pramipexole, and ropinirole alone or in combination with each other may be considered relatively safe during pregnancy. Expected benefits and risks should be considered when prescribing anti-PD medication in pregnant women.
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The study was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki.
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Tüfekçioğlu, Z., Hanağası, H., Yalçın Çakmaklı, G. et al. Use of anti-Parkinson medication during pregnancy: a case series. J Neurol 265, 1922–1929 (2018). https://doi.org/10.1007/s00415-018-8937-1
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DOI: https://doi.org/10.1007/s00415-018-8937-1