Long term health and neurodevelopment in children exposed to antiepileptic drugs before birth

John Dean, H. Hailey, S. J. Moore, David J Lloyd, P. D. Turnpenny, Julian Little

Research output: Contribution to journalArticle

172 Citations (Scopus)

Abstract

Objective: To investigate the frequency of neonatal and later childhood morbidity in children exposed to antiepileptic drugs in utero.

Design: Retrospective population based study.

Setting: Population of the Grampian region of Scotland.

Participants: Mothers taking antiepileptic drugs in pregnancy between 1976 and 2000 were ascertained from hospital obstetric records and 149 (58% of those eligible) took part. They had 293 children whose health and neurodevelopment were assessed.

Main outcome measures: Frequencies of neonatal withdrawal, congenital malformations, childhood onset medical problems, developmental delay, and behaviour disorders.

Results: Neonatal withdrawal was seen in 20% of those exposed to antiepileptic drugs. Congenital malformations occurred in 14% of exposed pregnancies, compared with 5% of non-exposed sibs, and developmental delay in 24% of exposed children, compared with 11% of non-exposed sibs. After excluding cases with a family history of developmental delay, 19% of exposed children and 3% of non-exposed sibs had developmental delay, 24% of exposed children had either major malformations or developmental delay, 52% of exposed children had facial dysmorphism compared with 25% of those not exposed, 31% of exposed children had childhood medical problems (13% of non-exposed sibs), and 20% had behaviour disorders (5% of non-exposed).

Conclusion: Prenatal antiepileptic drug exposure in the setting of maternal epilepsy is associated with developmental delay and later childhood morbidity in addition to congenital malformation.

Original languageEnglish
Pages (from-to)251-259
Number of pages8
JournalJournal of Medical Genetics
Volume39
Issue number4
DOIs
Publication statusPublished - 2002

Keywords

  • FETAL VALPROATE SYNDROME
  • IN-UTERO
  • SPINA-BIFIDA
  • CARBAMAZEPINE MONOTHERAPY
  • ANTICONVULSANT SYNDROMES
  • EPILEPTIC MOTHERS
  • PREGNANCY
  • MALFORMATIONS
  • ACID
  • PHENYTOIN

Cite this

Long term health and neurodevelopment in children exposed to antiepileptic drugs before birth. / Dean, John; Hailey, H.; Moore, S. J.; Lloyd, David J; Turnpenny, P. D.; Little, Julian.

In: Journal of Medical Genetics, Vol. 39, No. 4, 2002, p. 251-259.

Research output: Contribution to journalArticle

Dean, John ; Hailey, H. ; Moore, S. J. ; Lloyd, David J ; Turnpenny, P. D. ; Little, Julian. / Long term health and neurodevelopment in children exposed to antiepileptic drugs before birth. In: Journal of Medical Genetics. 2002 ; Vol. 39, No. 4. pp. 251-259.
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abstract = "Objective: To investigate the frequency of neonatal and later childhood morbidity in children exposed to antiepileptic drugs in utero.Design: Retrospective population based study.Setting: Population of the Grampian region of Scotland.Participants: Mothers taking antiepileptic drugs in pregnancy between 1976 and 2000 were ascertained from hospital obstetric records and 149 (58{\%} of those eligible) took part. They had 293 children whose health and neurodevelopment were assessed.Main outcome measures: Frequencies of neonatal withdrawal, congenital malformations, childhood onset medical problems, developmental delay, and behaviour disorders.Results: Neonatal withdrawal was seen in 20{\%} of those exposed to antiepileptic drugs. Congenital malformations occurred in 14{\%} of exposed pregnancies, compared with 5{\%} of non-exposed sibs, and developmental delay in 24{\%} of exposed children, compared with 11{\%} of non-exposed sibs. After excluding cases with a family history of developmental delay, 19{\%} of exposed children and 3{\%} of non-exposed sibs had developmental delay, 24{\%} of exposed children had either major malformations or developmental delay, 52{\%} of exposed children had facial dysmorphism compared with 25{\%} of those not exposed, 31{\%} of exposed children had childhood medical problems (13{\%} of non-exposed sibs), and 20{\%} had behaviour disorders (5{\%} of non-exposed).Conclusion: Prenatal antiepileptic drug exposure in the setting of maternal epilepsy is associated with developmental delay and later childhood morbidity in addition to congenital malformation.",
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AU - Dean, John

AU - Hailey, H.

AU - Moore, S. J.

AU - Lloyd, David J

AU - Turnpenny, P. D.

AU - Little, Julian

PY - 2002

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N2 - Objective: To investigate the frequency of neonatal and later childhood morbidity in children exposed to antiepileptic drugs in utero.Design: Retrospective population based study.Setting: Population of the Grampian region of Scotland.Participants: Mothers taking antiepileptic drugs in pregnancy between 1976 and 2000 were ascertained from hospital obstetric records and 149 (58% of those eligible) took part. They had 293 children whose health and neurodevelopment were assessed.Main outcome measures: Frequencies of neonatal withdrawal, congenital malformations, childhood onset medical problems, developmental delay, and behaviour disorders.Results: Neonatal withdrawal was seen in 20% of those exposed to antiepileptic drugs. Congenital malformations occurred in 14% of exposed pregnancies, compared with 5% of non-exposed sibs, and developmental delay in 24% of exposed children, compared with 11% of non-exposed sibs. After excluding cases with a family history of developmental delay, 19% of exposed children and 3% of non-exposed sibs had developmental delay, 24% of exposed children had either major malformations or developmental delay, 52% of exposed children had facial dysmorphism compared with 25% of those not exposed, 31% of exposed children had childhood medical problems (13% of non-exposed sibs), and 20% had behaviour disorders (5% of non-exposed).Conclusion: Prenatal antiepileptic drug exposure in the setting of maternal epilepsy is associated with developmental delay and later childhood morbidity in addition to congenital malformation.

AB - Objective: To investigate the frequency of neonatal and later childhood morbidity in children exposed to antiepileptic drugs in utero.Design: Retrospective population based study.Setting: Population of the Grampian region of Scotland.Participants: Mothers taking antiepileptic drugs in pregnancy between 1976 and 2000 were ascertained from hospital obstetric records and 149 (58% of those eligible) took part. They had 293 children whose health and neurodevelopment were assessed.Main outcome measures: Frequencies of neonatal withdrawal, congenital malformations, childhood onset medical problems, developmental delay, and behaviour disorders.Results: Neonatal withdrawal was seen in 20% of those exposed to antiepileptic drugs. Congenital malformations occurred in 14% of exposed pregnancies, compared with 5% of non-exposed sibs, and developmental delay in 24% of exposed children, compared with 11% of non-exposed sibs. After excluding cases with a family history of developmental delay, 19% of exposed children and 3% of non-exposed sibs had developmental delay, 24% of exposed children had either major malformations or developmental delay, 52% of exposed children had facial dysmorphism compared with 25% of those not exposed, 31% of exposed children had childhood medical problems (13% of non-exposed sibs), and 20% had behaviour disorders (5% of non-exposed).Conclusion: Prenatal antiepileptic drug exposure in the setting of maternal epilepsy is associated with developmental delay and later childhood morbidity in addition to congenital malformation.

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KW - EPILEPTIC MOTHERS

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KW - MALFORMATIONS

KW - ACID

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