title: Cognitive functions in children exposed to antiepileptic drugs in utero - Study in Georgia.
abstract: The cognitive teratogenicity of antiepileptic drugs (AEDs) has gained increasing attention in the last decade. The objective of the current study was to assess the effects of AED fetal exposure on the cognitive development of children of mothers with epilepsy from Georgia in a controlled study taking into consideration major confounding factors.
  
  
  
  A prospective cohort group was formed from children and mothers registered in the Georgian National AED-Pregnancy Registry. The study group's age- and gender-matched control children without fetal AED exposure were selected retrospectively. The Intelligence Quotient (IQ) using the Wechsler Adult Intelligence Scale - revised (WAIS-R) was assessed in mothers. The Wechsler Preschool and Primary Scale of Intelligence (WPPSI-4) were used to assess intellectual functioning for children of both study and control groups. Linear regression analysis was performed to detect association of AED exposure on the cognitive performance of children.
  
  
  
  In total, 100 children aged 36 to 72months were evaluated. The IQ of WWE was significantly lower compared to women without epilepsy in all modalities. Exposure to valproate (VPA) (n=18) was associated with lowest cognitive performance regarding Full Scale IQ (FSIQ) (β, -12.04; p=0.006) and verbal comprehension (VCI) (β, -8.89; p=0.019). Maternal FSIQ, maternal performance IQ (PIQ), and child's age at first phrases were independent factors associated with the cognitive development of children.
  
  
  
  Multivariate analysis showed VPA to be an independent predictor for decreased cognitive performance. Maternal FSIQ, PIQ, and child developmental achievements were significant confounders for cognitive performance in children.
authors.affiliation: Epilepsy Prevention and Control Centre, Institute of Neurology and Neuropsychology, 83/11, Vazha-Pshavela Ave. 0186, Tbilisi, Georgia. Electronic address: sofiakas@gmail.com.
authors.forename: Sofia
authors.initials: S
authors.lastname: Kasradze
authors.affiliation: Epilepsy Prevention and Control Centre, Institute of Neurology and Neuropsychology, 83/11, Vazha-Pshavela Ave. 0186, Tbilisi, Georgia. Electronic address: nino_gogat@yahoo.com.
authors.forename: Nino
authors.initials: N
authors.lastname: Gogatishvili
authors.affiliation: Epilepsy Prevention and Control Centre, Institute of Neurology and Neuropsychology, 83/11, Vazha-Pshavela Ave. 0186, Tbilisi, Georgia. Electronic address: lomidzegiorgi@yahoo.com.
authors.forename: Giorgi
authors.initials: G
authors.lastname: Lomidze
authors.affiliation: Epilepsy Prevention and Control Centre, Institute of Neurology and Neuropsychology, 83/11, Vazha-Pshavela Ave. 0186, Tbilisi, Georgia. Electronic address: ediberidzet@yahoo.com.
authors.forename: Tamar
authors.initials: T
authors.lastname: Ediberidze
authors.affiliation: Epilepsy Prevention and Control Centre, Institute of Neurology and Neuropsychology, 83/11, Vazha-Pshavela Ave. 0186, Tbilisi, Georgia. Electronic address: lazariashvilimari@ymail.com.
authors.forename: Marine
authors.initials: M
authors.lastname: Lazariashvili
authors.affiliation: Epilepsy Prevention and Control Centre, Institute of Neurology and Neuropsychology, 83/11, Vazha-Pshavela Ave. 0186, Tbilisi, Georgia. Electronic address: kkhomeriki@yahoo.com.
authors.forename: Ketevan
authors.initials: K
authors.lastname: Khomeriki
authors.affiliation: Epilepsy Prevention and Control Centre, Institute of Neurology and Neuropsychology, 83/11, Vazha-Pshavela Ave. 0186, Tbilisi, Georgia; Iv. Javakhishvili Tbilisi State University, 1, I. Chavchavadze Ave. 0179, Tbilisi, Georgia. Electronic address: sh.mamukadze@gmail.com.
authors.forename: Shorena
authors.initials: S
authors.lastname: Mamukadze
authors.affiliation: Epilepsy Prevention and Control Centre, Institute of Neurology and Neuropsychology, 83/11, Vazha-Pshavela Ave. 0186, Tbilisi, Georgia; Iv. Javakhishvili Tbilisi State University, 1, I. Chavchavadze Ave. 0179, Tbilisi, Georgia. Electronic address: metrmari01@gmail.com.
authors.forename: Mariam
authors.initials: M
authors.lastname: Metreveli
authors.affiliation: Epilepsy Prevention and Control Centre, Institute of Neurology and Neuropsychology, 83/11, Vazha-Pshavela Ave. 0186, Tbilisi, Georgia; Iv. Javakhishvili Tbilisi State University, 1, I. Chavchavadze Ave. 0179, Tbilisi, Georgia. Electronic address: gagoshidzet@gmail.com.
authors.forename: Tamar
authors.initials: T
authors.lastname: Gagoshidze
authors.affiliation: Department of Neuroscience of the Central Children Hospital, 2/6, Lubliana Str. 0159, Tbilisi, Georgia. Electronic address: n_tatishvili@hotmail.com.
authors.forename: Nino
authors.initials: N
authors.lastname: Tatishvili
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institutet, 18A, Tomtebodavägen, 17177 Stockholm, Sweden. Electronic address: torbjorn.tomson@karolinska.se.
authors.forename: Torbjörn
authors.initials: T
authors.lastname: Tomson
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D002657:Child Development / Q000187:drug effects / Q000502:physiology; D002675:Child, Preschool; D003071:Cognition / Q000187:drug effects* / Q000502:physiology; D015331:Cohort Studies; D004827:Epilepsy / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D005846:Georgia (Republic) / Q000453:epidemiology; D006801:Humans; D007360:Intelligence / Q000187:drug effects / Q000502:physiology; D007361:Intelligence Tests; D008297:Male; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy* / Q000453:epidemiology*; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology*; D011446:Prospective Studies; D014635:Valproic Acid / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D014635:Valproic Acid
keywords: Cognitive teratogenicity; Fetal AED exposure; Multivariate analysis