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Physical and psychomotor development in the offspring born to mothers with epilepsy
Takayuki Hirano1, Kuniko Fujioka, Motohiro Okada
1National Minamihanamaki Hospital, Hirosaki University, Hirosaki, Japan.
Insights
Children born to mothers with epilepsy show developmental impacts from antiepileptic drugs (AEDs) and maternal seizures, especially in early childhood. Later development is influenced by the child-rearing environment and maternal skills.
Area of Science:
- Neurology
- Developmental Pediatrics
- Pharmacology
Background:
- Epilepsy in mothers can pose risks to offspring development.
- Antiepileptic drugs (AEDs) and maternal seizures are potential teratogenic factors.
- Understanding long-term developmental outcomes is crucial for intervention.
Purpose of the Study:
- To prospectively assess the psychomotor development of children born to mothers with epilepsy.
- To identify factors influencing developmental quotient (DQ) scores in these children.
- To compare developmental trajectories with matched controls.
Main Methods:
- Prospective study of 71 children of mothers with epilepsy and 99 matched controls.
- Developmental assessments at 1.5 and 3 years of age.
- Analysis of factors including intrauterine AED exposure, maternal seizures, birth head circumference, maternal education, and child-rearing environment.
Main Results:
- Intrauterine growth retardation resolved by age 3.
- Early development (1.5 years) was negatively impacted by AED dose, maternal seizures, and smaller head circumference at birth.
- Motor and linguistic abilities were affected.
- At 3 years, maternal education became a significant factor, particularly for linguistic skills.
- Maternal seizure type (complex vs. simple partial) also influenced motor development at 3 years.
- Environmental factors and maternal child-rearing ability gained importance with age.
Conclusions:
- Maternal epilepsy and its treatment can affect child psychomotor development.
- Early developmental deficits may be linked to in utero exposures and birth parameters.
- Child care environment and maternal skills play a more significant role in later development.
- Regular developmental monitoring and potential support, like day nurseries, are recommended for children of mothers with epilepsy.
Abstract:
Psychomotor development of 71 children born to mothers with epilepsy was prospectively studied and compared to those of 99 controls matched for age, maternal educational level and age, and socioeconomic status. Intrauterine growth retardation disappeared before age 3 years. Assessment at age 1.5 years revealed that exposure to seizures, high dose of antiepileptic drugs (AEDs) in utero, and small head circumference at birth affected development quotient (DQ) scores of motor or linguistic abilities or both. DQ scores of motor ability of children of mothers with complex partial seizures were lower than those with simple partial seizures when assessed at age 3 years. Assessments at age 1.5 years revealed that the total daily dose of AEDs correlated negatively with DQ scores of motor ability, and at age 3 years, maternal educational level affected DQ scores of some fields, including linguistic ability. The effects of AED exposure in utero and the occurrence of maternal seizures on the development of offspring were found to matter more at the younger age, but later on, the child care environment and, in particular, maternal ability of child-rearing, became more important. Our findings indicate that careful and regular follow-ups are needed to monitor the developmental stages of children of mothers with epilepsy, and the introduction of a day nursery should be suggested if necessary.
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