{
  "abstract": "Background Onabotulinum Toxin-A has been used in clinical practice in Australia for over 30 years in neurological conditions. However, much trial data excluded women who were pregnant and there is limited safety data of Onabotulinum Toxin-A in pregnancy.Methods A record search was conducted for patients treated with Onabotulinum Toxin-A at a single practice in Sydney from 2000 to 2023. The study was granted ethics approval. 152 women of childbearing age treated with Onabotulinum Toxin-A. Detailed chart review for nine patients treated during pregnancy was conducted.Results Nine patients were treated with Onabotulinum Toxin-A throughout pregnancy. Six received treatment for chronic migraine. All maintained headache control during pregnancy. One patient was treated for hemifacial spasm and two for torticollis. All had previously received Onabotulinum Toxin-A prior to conception. All nine pregnancies proceeded to term. There were no patient-reported complications during any of the pregnancies, deliveries or perinatal periods.Conclusion This retrospective Australian case series provides local data for use of Onabotulinum Toxin-A during pregnancy in collaboration with perinatal health care providers with positive outcomes. The study is not large enough to draw further conclusions and further discussion regarding local practice is advocated. Results are consistent with Brin et al.,1 who documented class III data in 195 pregnancies and 152 births showing prevalence of major fetal defects is consistent with background population rates. Onabotulinum Toxin-A use in pregnancy could be a better option than oral migraine preventative agents currently used as it is highly protein bound and lacking systemic effects on mother or baby.Reference Brin MF, Kirby RS, Slavotinek A, Adams AM, Parker L, Ukah A, Radulian L, Elmore MRP, Yedigarova L, Yushmanova I. Pregnancy outcomes in patients exposed to onabotulinum toxin-A treatment: a cumulative 29-year safety update. Neurology 2023 Jul 11;101(2):e103–e113.",
  "authors": [
    {
      "affiliations": [
        "Neurology, Sunshine Coast University Hospital, Sunshine Coast, QLD, Australia"
      ],
      "name": "Jasmin Tilling"
    },
    {
      "affiliations": [
        "Obstetric Medicine, Prince of Wales Hospital, Sydney, NSW, Australia"
      ],
      "name": "Debra Kennedy"
    },
    {
      "affiliations": [
        "Obstetric Medicine, Royal Women’s Hospital, Sydney, NSW, Australia"
      ],
      "name": "Sandra Lowe"
    },
    {
      "affiliations": [
        "Neurology, St Vincent’s Hospital, Darlinghurst, NSW, Australia"
      ],
      "name": "Paul Darveniza"
    },
    {
      "affiliations": [
        "Neurology, St Vincent’s Hospital, Darlinghurst, NSW, Australia"
      ],
      "name": "Usman Ashraf"
    },
    {
      "affiliations": [
        "Neurology, St Vincent’s Hospital, Darlinghurst, NSW, Australia"
      ],
      "name": "Susan E Tomlinson"
    }
  ],
  "title": "3506 Onabotulinum toxin-A use in pregnancy – an Australian retrospective review of real-world clinical experience",
  "uid": "cf3fa05a-c892-55af-9fb3-c8d791ad22f8"
}