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Child development following in utero exposure: levetiracetam vs sodium valproate

R Shallcross1, R L Bromley, B Irwin

  • 1Division of Neurosciences, University of Liverpool, UK.

Neurology
|January 26, 2011
PubMed

Insights

Children exposed to levetiracetam (LEV) in utero show no increased risk of developmental delays by age two. LEV appears to be a safer choice for women with epilepsy (WWE) compared to sodium valproate (VPA).

Area of Science:

  • Neuroscience
  • Developmental Pediatrics
  • Pharmacology

Background:

  • Epilepsy in women of childbearing age necessitates careful medication management.
  • Antiepileptic drugs (AEDs) carry potential risks for fetal development.
  • Levetiracetam (LEV) and sodium valproate (VPA) are commonly used AEDs with differing safety profiles.

Purpose of the Study:

  • To assess the early cognitive development of children exposed in utero to LEV.
  • To compare cognitive outcomes between children exposed to LEV, VPA, and a general population control group.
  • To determine if in utero LEV exposure is associated with delayed early cognitive development.

Main Methods:

  • Prospective observational study of children from UK cohorts, assessed <24 months.
  • Griffiths Mental Development Scale (1996) used for cognitive assessment.
  • Maternal demographics and epilepsy status were collected and controlled for.

Main Results:

  • Children exposed to LEV demonstrated significantly higher developmental scores than those exposed to VPA (p < 0.001).
  • No significant difference in overall development was observed between LEV-exposed children and the control group (p = 0.62).
  • Only 8% of LEV-exposed children had below-average scores, compared to 40% of VPA-exposed children.

Conclusions:

  • In utero exposure to LEV is not associated with an increased risk of delayed early cognitive development up to 24 months.
  • LEV may be a preferred AED for women with epilepsy (WWE) of childbearing age.
  • These findings support the use of LEV in pregnancy when clinically indicated.
Abstract

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