Long term health and neurodevelopment in children exposed to antiepileptic drugs before birth.
OBJECTIVE
To investigate the frequency of neonatal and later childhood morbidity in children exposed to antiepileptic drugs in utero.


METHODS
Retrospective population based study.


METHODS
Population of the Grampian region of Scotland.


METHODS
Mothers taking antiepileptic drugs in pregnancy between 1976 and 2000 were ascertained from hospital obstetric records and 149 (58% of those eligible) took part. They had 293 children whose health and neurodevelopment were assessed.


METHODS
Frequencies of neonatal withdrawal, congenital malformations, childhood onset medical problems, developmental delay, and behaviour disorders.


RESULTS
Neonatal withdrawal was seen in 20% of those exposed to antiepileptic drugs. Congenital malformations occurred in 14% of exposed pregnancies, compared with 5% of non-exposed sibs, and developmental delay in 24% of exposed children, compared with 11% of non-exposed sibs. After excluding cases with a family history of developmental delay, 19% of exposed children and 3% of non-exposed sibs had developmental delay, 31% of exposed children had either major malformations or developmental delay, 52% of exposed children had facial dysmorphism compared with 25% of those not exposed, 31% of exposed children had childhood medical problems (13% of non-exposed sibs), and 20% had behaviour disorders (5% of non-exposed).


CONCLUSIONS
Prenatal antiepileptic drug exposure in the setting of maternal epilepsy is associated with developmental delay and later childhood morbidity in addition to congenital malformation.
Dean
J C S
JC
Department of Medical Genetics, Medical School, Foresterhill, Aberdeen AB25 2ZD, UK. j.dean@abdn.ac.uk
Hailey
H
H
Moore
S J
SJ
Lloyd
D J
DJ
Turnpenny
P D
PD
Little
J
J
D000014:Abnormalities, Drug-Induced / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D002653:Child Behavior Disorders / Q000139:chemically induced; D002675:Child, Preschool; D003072:Cognition Disorders / Q000139:chemically induced; D002658:Developmental Disabilities / Q000139:chemically induced; D004305:Dose-Response Relationship, Drug; D004827:Epilepsy / Q000188:drug therapy* / Q000503:physiopathology; D005145:Face / Q000002:abnormalities; D005260:Female; D005315:Fetal Diseases / Q000139:chemically induced* / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018811:Maternal Exposure / Q000009:adverse effects*; D008487:Medical History Taking / Q000379:methods; D009357:Neonatal Abstinence Syndrome / Q000209:etiology; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects
D000927:Anticonvulsants