Early cognitive development in children born to women with epilepsy: a prospective report.
OBJECTIVE
In this prospective study the early cognitive development of children born to women with epilepsy (n = 198) was assessed and compared to a group of children representative of the general population (n = 230).


METHODS
The children were assessed when younger than the age of 2 years using the Griffiths Mental Development Scales, either in their local participating hospital or in their home. The assessments were completed by an assessor who was blinded to whether the child's mother had epilepsy and to antiepileptic drug type.


RESULTS
Children exposed to sodium valproate had a statistically significant increased risk of delayed early development in comparison to the control children. Linear regression analysis showed a statistically significant effect of sodium valproate exposure on the child's overall developmental level that was not accounted for by confounding variables. Delayed early development is also noted for children within an ad hoc group of less commonly utilized antiepileptic drugs, although conclusions cannot be drawn due to the size of this group (n = 13). Children exposed to either carbamazepine or lamotrigine in utero did not differ significantly in their overall developmental ability. Differences noted in specific developmental areas for these two groups were not statistically significant after the control for confounders such as socioeconomic status and maternal IQ.


CONCLUSIONS
Women with epilepsy should be informed of the risks posed to their potential offspring prior to pregnancy to allow for informed decisions regarding treatment. Children exposed in utero to antiepileptic drugs should be monitored throughout childhood to allow for early intervention when necessary.
Bromley
Rebecca L
RL
Department Neurological Science, University of Liverpool, United Kingdom.
Mawer
George
G
Love
Jenna
J
Kelly
James
J
Purdy
Laura
L
McEwan
Lauren
L
Briggs
Maria
M
Clayton-Smith
Jill
J
Shi
Xin
X
Sin
Xin
X
Baker
Gus A
GA
D000367:Age Factors; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D016241:Child of Impaired Parents / Q000523:psychology*; D003071:Cognition / Q000187:drug effects; D003072:Cognition Disorders / Q000139:chemically induced* / Q000175:diagnosis; D002658:Developmental Disabilities / Q000139:chemically induced*; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007223:Infant; D007360:Intelligence / Q000187:drug effects; D009035:Mothers / Q000523:psychology / Q000706:statistics & numerical data; D009483:Neuropsychological Tests; D011247:Pregnancy; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D012923:Social Class; D014635:Valproic Acid / Q000009:adverse effects / Q000627:therapeutic use
D000927:Anticonvulsants; D014635:Valproic Acid