Study: Antiepileptic Drugs Taken in Utero Lead to Delays in Children

in_uterp_eplipetic_drugsChildren whose mothers were exposed to antiepileptic medications during pregnancy were likelier to have abnormal scores on tests on motor development and autism traits, a new study reveals.

When tested at 18 and 36 months the children’s data revealed they were twice as likely to have abnormal test scores related to motor and sentence skills, according to MedPage Today. Autistic traits were seen two-to-three times more often in children who experienced in utero epilepsy drug exposure.

These findings, noted MedPage Today, add to prior evidence linking epilepsy drugs to congenital defects, concluded Gyri Veiby, MD, of Haukeland University Hospital in Bergen, Norway, and co-authors in an article published online in Epilepsia. “Exposures to valproate, lamotrigine, carbamazepine, or multiple antiepileptic drugs were associated with adverse outcome within different developmental domains,” the authors concluded. Lomotrigine is sold under the brand Lamictal and carbamazepine is sold under the brands Tegretol, Carbatrol, Equetro, and Epitol.

“Treatment that provides optimal seizure control is important during pregnancy, but should be balanced against potential effects on the fetal brain,” the study authors added. “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,” they pointed out, according to MedPage Today.

While use of epilepsy medications during pregnancy has long been associated with congenital malformations, the drugs’ impact on cognitive development is less understood. Studies have linked in utero exposure to the drugs to impairments associated with psychomotor function, language development, IQ scoring, and behavioral problems, the authors say, wrote MedPage Today.

The team analyzed data from children whose mothers were diagnosed with epilepsy but were untreated and who whose fathers were diagnosed with epilepsy, according to MedPage Today. Data was derived from the Norwegian Mother and Child Cohort Study (MoBa), an ongoing study seeking to determine the causes for various diseases in mothers and their babies.

From mid-1999 through 2008, 108,976 children were registered with the MoBa study, which included 726 children whose mothers were diagnosed with epilepsy and 653 children whose fathers were diagnosed with epilepsy. Children undergo assessments at 6, 18, and 36 months. Motor, communication, and social skills are evaluated during at least one of these assessments, MedPage Today explained; 333 of the children were exposed in utero to antiepileptic drugs.

In addition to higher abnormal scores for gross motor skills, autistic traits, and sentence skills in children exposed to the drugs in utero, there were also increases in congenital malformations in these children when compared to the unexposed group, MedPage Today reported. Children with one parent who was diagnosed with epilepsy but who were not exposed to antiepileptic medications during pregnancy showed no increased risks for abnormal developmental scores.

We recently wrote that another study found that valproate use by pregnant women was associated with a significantly increased risk of their babies developing autism, according to a study in the Journal of the American Medical Association. Valproate has also been linked to increased risks for congenital malformations and delayed cognitive development; little information is available on valproate’s risks for other significant neuropsychiatric disorders. Also, a prior Danish study revealed additional evidence that fetal exposure to Depakote, specifically its active ingredient, valproate, increases a baby’s risk of developing autism spectrum disorders (ASD) three-fold. Depakote, approved for the prevention of migraines, treating acute manic episodes in bipolar patients, and halting seizures in adults and children, has been associated with birth defects when taken by pregnant women.

Just prior, 26 women filed lawsuits claiming that the makers of Depakote illegally marketed the drug for off-label purposes and failed to warn of the side effects of the drug. Each of the women claimed they were prescribed and took Depakote just before getting pregnant or during the first trimester of their pregnancy and that the drug caused them to give birth to children with a wide array of severe, some life-threatening, birth defects.

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