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Children exposed to antiepileptic drugs in utero at increased risk for developmental issues

Children whose mothers took antiepileptic drugs during their pregnancy are at increased risk for early developmental issues, according to new study findings.

“Treatment that provides optimal seizure control is important during pregnancy, but should be balanced against potential effects on the fetal brain,” Gyri Veiby, MD, of Haukeland University Hospital in Norway, and colleagues wrote. “Difficulties at an early age, that is, minor motor delay, can be temporary, but other effects may continue or even worsen as the child develops. Further research should focus on in utero effects of specific antiepileptic drugs in larger cohorts, and whether such effects persist into school-age and adulthood.”

The study included 333 children from the Norwegian Mother and Child Cohort Study who were exposed to antiepileptic drugs in utero.

Researchers found that at aged 18 months participants had an increased risk for abnormal scores for gross motor skills (OR=2; 95% CI, 1.1-3.7) and autistic traits (OR=2.7; 95% CI, 1.1-6.7). At aged 36 months participants still had an increased risk for abnormal scores for gross motor skills (OR=2.2; 95% CI, 1.1-4.2) and autistic traits (OR=3.4; 95% CI, 1.6-7). Participants also had increased risk for congenital malformations (OR=2.1; 95% CI, 1.4-3.4). Children of mothers with epilepsy not using antiseizure medication, and of fathers with epilespy, generally scored within the normal range.

“Many women using antiepileptic drugs do not receive the appropriate pre-pregnancy counseling, which is unfortunate,” Veiby told Psychiatric Annals. “Several measures can be undertaken in advance to minimize the risk for the fetus, that is, lowering the drug-dose, changing to a presumably less teratogenic drug, or even a trial period without drug treatment if there have been many years of seizure-freedom.”

Disclosure: Some researchers report financial relationships with GlaxoSmithKline, Lundbeck and UCB Pharma.