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Intelligence of children of epileptic mothers
E Gaily1, E Kantola-Sorsa, M L Granström
1Clinic of Pediatrics, University of Helsinki, Finland.
Insights
Children of epileptic mothers had lower average intelligence scores, but antiepileptic drugs or maternal seizures did not increase the risk of low intelligence. Minor anomalies were linked to lower IQ in all children.
Area of Science:
- Neuroscience
- Developmental Psychology
- Pediatrics
Background:
- Epilepsy in mothers can pose risks to fetal development.
- Antiepileptic drugs (AEDs) are often prescribed during pregnancy.
- Understanding the long-term intellectual outcomes for children exposed to maternal epilepsy and AEDs is crucial.
Purpose of the Study:
- To investigate intellectual performance in children of epileptic mothers compared to controls.
- To assess the impact of in utero exposure to antiepileptic drugs and maternal seizures on child intelligence.
- To explore associations between minor anomalies, maternal epilepsy, and intellectual development.
Main Methods:
- Prospective study of 148 children of epileptic mothers and 105 controls, assessed at 5 1/2 years.
- Intelligence assessed using verbal (Wechsler Preschool and Primary Scale of Intelligence) and nonverbal (Leiter International Performance Scale) tests.
- Prevalence of mental deficiency evaluated through psychologic assessments and school achievement.
Main Results:
- Mean intelligence quotients were significantly lower in the study group (children of epileptic mothers) compared to controls.
- No increased risk of low intelligence was found for fetal exposure to AEDs below toxic levels or brief maternal convulsions.
- A high number of minor anomalies correlated with lower mean IQ in both study and control groups.
Conclusions:
- While children of epileptic mothers showed lower average IQ, specific factors like AEDs or maternal seizures did not elevate the risk of intellectual deficiency.
- Genetic factors may play a role in the observed intellectual differences in some cases.
- Minor anomalies are associated with reduced intellectual performance, irrespective of maternal epilepsy or AED exposure.
Abstract:
Intellectual performance was investigated in a group of 148 children of epileptic mothers enrolled in a prospective study during pregnancy, and in 105 control children; 121 of the 148 children (82%) were examined together with the control group at the age of 5 1/2 years. The intelligence of 116 study and 104 control children was assessed by both verbal (Wechsler Preschool and Primary Scale of Intelligence) and nonverbal (Leiter International Performance Scale) methods. The prevalence of mental subnormality among the remaining 32 study children was calculated on the basis of psychologic assessments done outside our study, or school achievement, or both. Of the 148 study group children, 131 had been exposed in utero to antiepileptic drugs, most commonly phenytoin (103 exposed). The prevalence of mental deficiency in the study group (1.4%) was either the same or only slightly elevated in comparison with that in the general population. In the control group, there were no mentally deficient children. The mean intelligence quotients obtained at the 5 1/2-year examination were significantly lower in the study group than in the control group. There was no increased risk of low intelligence attributable to fetal exposure either to antiepileptic drugs below toxic levels or to brief maternal convulsions. In a few cases, there seemed to be a genetic connection between epilepsy in the mother and poor intellectual performance in the child. A high number of minor anomalies was associated with a lower mean intelligence quotient in both the study and the control groups. However, those features previously reported as typical of children of epileptic mothers, and those shown to be associated with phenytoin exposure in a previous phase of this study, did not predict low intelligence in the affected children.