title: Developmental outcomes at preschool age after fetal exposure to valproic acid and lamotrigine: cognitive, motor, sensory and behavioral function.
abstract: This prospective, observational study assessed the development of preschool children aged 3-6 years, 11 months (n=124) after in-utero anti-epileptic drug (AED) monotherapy exposure to valproic acid (VPA) (n=30, mean age 52.00[±15.22] months) and lamotrigine (LT) (n=42, mean age 50.12[±12.77] months), compared to non-exposed control children (n=52, mean age 59.96[±14.51] months). As a combined group, AED-exposed children showed reduced non-verbal IQ scores, and lower scores on motor measures, sensory measures, and parent-report executive function, behavioral and attentional measures. When the VPA- and LT-exposed groups were analyzed separately, no cognitive differences were found, but control-VPA and control-LT differences emerged for most motor and sensory measures as well as control-VPA parent-report behavioral and attentional differences. No differences were noted between the VPA and LT groups. These findings suggest that VPA- and LT-exposed children should be monitored on a wider range of developmental measures than currently used, and at differing developmental stages.
authors.affiliation: School of Occupational Therapy of Hadassah and the Faculty of Medicine, Hebrew University of Jerusalem, Israel. tanya@tanya-branko.com
authors.forename: Tanya
authors.initials: T
authors.lastname: Rihtman
authors.forename: Shula
authors.initials: S
authors.lastname: Parush
authors.forename: Asher
authors.initials: A
authors.lastname: Ornoy
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects*; D001288:Attention / Q000187:drug effects; D001519:Behavior / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D003071:Cognition / Q000187:drug effects; D005178:Faculty; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D008297:Male; D008431:Maternal-Fetal Exchange; D009048:Motor Skills / Q000187:drug effects; D010290:Parents; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014227:Triazines / Q000009:adverse effects*; D014635:Valproic Acid / Q000009:adverse effects*
chemical_list: D000927:Anticonvulsants; D014227:Triazines; D014635:Valproic Acid; D000077213:Lamotrigine
keywords: Developmental outcomes; Intra-uterine AED exposure; Lamotrigine; Monotherapy; Valproic acid