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Long-term consequences after exposure to antiepileptic drugs in utero

Lisa Forsberg1, Katarina Wide1

  • 1Astrid Lindgren Children's Hospital at Karolinska University Hospital Huddinge and Department of Clinical Science, Intervention and Technique (CLINTEC), Karolinska Institutet, Stockholm, Sweden.

Therapeutic Advances in Drug Safety
|August 2, 2014
PubMed

Insights

Most pregnant women with epilepsy require medication. While some antiepileptic drugs pose risks to fetal development, carbamazepine and lamotrigine monotherapy appear safe for child cognition.

Area of Science:

  • Neurology
  • Pharmacology
  • Developmental Pediatrics

Background:

  • Epilepsy treatment during pregnancy often necessitates antiepileptic drugs (AEDs).
  • Prenatal exposure to AEDs is associated with increased risks of major malformations and potential adverse neurodevelopmental outcomes in children.

Purpose of the Study:

  • To evaluate the long-term neurodevelopmental effects of prenatal exposure to specific antiepileptic drugs in children.
  • To compare the safety profiles of monotherapy versus polytherapy AEDs during pregnancy.

Main Methods:

  • Review of existing studies on children exposed to AEDs in utero.
  • Analysis of neurodevelopmental outcomes, including major malformations and cognitive/psychomotor development.

Main Results:

  • Carbamazepine and lamotrigine monotherapy showed no significant negative impact on exposed children's cognition.
  • Valproic acid and polytherapy (two or more AEDs) were linked to negative long-term neurodevelopmental effects.
  • Limited data exist for newer AEDs regarding long-term outcomes.

Conclusions:

  • The choice of AED during pregnancy requires careful consideration of potential risks to fetal development.
  • Monotherapy with certain AEDs like carbamazepine and lamotrigine may be safer for neurodevelopment compared to others or polytherapy.
  • Further research is needed for newer AEDs to ascertain their long-term safety in pregnancy.

Keywords:
anticonvulsantschild developmentcognitiveepilepsyintelligenceneurodevelopmentpregnancy

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