title: Neurodevelopment of children exposed in utero to lamotrigine, sodium valproate and carbamazepine.
abstract: OBJECTIVE
  To establish the relative risks of in utero exposure to lamotrigine (LTG), sodium valproate (NaV) and carbamazepine (CBZ) monotherapy for neurodevelopment.
  
  
  METHODS
  Observational cohort study.
  
  
  METHODS
  The study group consisted of children in Northern Ireland aged 9-60 months born to mothers who had enrolled with the UK Epilepsy and Pregnancy Register. The control group consisted of children identified from the Child Health System database across Northern Ireland. Data were gathered on covariates recognised as influencing child development.
  
  
  METHODS
  Neurodevelopment assessed using either the Bayley Scales of Infant Development or the Griffiths Mental Development Scales.
  
  
  RESULTS
  210 children underwent assessment by a single researcher blinded to antiepileptic drug exposure. 23 (39.6%) children exposed in utero to NaV, 10 (20.4%) exposed to CBZ and one (2.9%) exposed to LTG had evidence of mild or significant developmental delay, compared to two (4.5%) children in the control group. Multivariable analysis demonstrated that in utero exposure to NaV (OR 26.1, 95% CI 4.9 to 139; p<0.001) and to CBZ (OR 7.7, 95% CI 1.4 to 43.1; p<0.01) but not to LTG had a significant detrimental effect on neurodevelopment.
  
  
  CONCLUSIONS
  In utero exposure to LTG did not have the detrimental effect on child development that was seen with NaV and with CBZ.
authors.affiliation: Bradbury Centre, 1-17 Lisburn Road, Belfast, UK. cliona.cummings@belfasttrust.hscni.net
authors.forename: Cliona
authors.initials: C
authors.lastname: Cummings
authors.forename: Moira
authors.initials: M
authors.lastname: Stewart
authors.forename: Mike
authors.initials: M
authors.lastname: Stevenson
authors.forename: Jim
authors.initials: J
authors.lastname: Morrow
authors.forename: Joanne
authors.initials: J
authors.lastname: Nelson
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D002220:Carbamazepine / Q000009:adverse effects / Q000627:therapeutic use; D016022:Case-Control Studies; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000139:chemically induced*; D004827:Epilepsy / Q000188:drug therapy; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D000077213:Lamotrigine; D008297:Male; D008431:Maternal-Fetal Exchange; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy; D011297:Prenatal Exposure Delayed Effects / Q000523:psychology*; D014227:Triazines / Q000009:adverse effects / Q000627:therapeutic use; D014635:Valproic Acid / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D014227:Triazines; D002220:Carbamazepine; D014635:Valproic Acid; D000077213:Lamotrigine