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Updated: Mar 28, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Effects of prenatal antiepileptic drug exposure on newborn brain activity
Mari Videman1, Anton Tokariev2,3, Susanna Stjerna3,4
1Department of Pediatric Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Insights
Prenatal exposure to antiepileptic drugs (AEDs) can affect newborn brain activity and neurological status within the first two weeks of life. These early changes in cortical activity may indicate risks for later neurodevelopmental issues.
Area of Science:
- Neonatal neurology
- Developmental neuroscience
- Pharmacology
Background:
- Prenatal exposure to antiepileptic drugs (AEDs) is linked to later cognitive deficits.
- Early detection of adverse effects is crucial for understanding neurodevelopmental trajectories.
Purpose of the Study:
- To determine if adverse drug effects on brain function are detectable in newborns exposed prenatally to AEDs.
- To investigate early cortical activity and neurological status in the first two weeks of life.
Main Methods:
- Prospective study of 56 AED-exposed and 67 unexposed newborns.
- Clinical neurological assessment using Hammersmith Neonatal Neurological Examination.
- Electroencephalography (EEG) with automated quantitation of oscillatory activity, frequency spectra, synchrony, and interburst intervals.
Main Results:
- AED-exposed newborns showed differences in limb/axial tone and irritability.
- Significant EEG differences observed in alpha bouts, frequency spectra, interhemispheric synchrony, and interburst intervals.
Conclusions:
- Fetal AED exposure impacts early neonatal neurological status and cortical activity.
- Activity-dependent network development interference is a potential mechanism for later neurocognitive sequelae.
Objective:
Prenatal exposure to antiepileptic drugs (AEDs) is associated with an increased risk of cognitive dysfunction at early school age. Our aim was to investigate whether signs of adverse drug effects on brain function could be detected already during the first 2 weeks of life.
Methods:
We studied prospectively 56 full-term newborns with prenatal exposure to AEDs and 67 unexposed newborns for the following characteristics: Background information, AED exposure data, pregnancy outcome, neuropsychological evaluation of the mothers, clinical neurologic status with Hammersmith Neonatal Neurological Examination and early cortical activity using electroencephalography (EEG). For EEG assessment, we developed and provide automated quantitation algorithms of several earlier described features: oscillatory bouts at theta and alpha frequencies, frequency spectra, interhemispheric synchrony, and interburst intervals (IBIs).
Results:
The AED-exposed newborns had lower limb and axial tone and were less irritable than the unexposed newborns. EEG assessment disclosed significant differences in alpha bouts, in the frequency spectra, as well as in the spatial distributions of interhemispheric synchrony and IBIs.
Significance:
The results indicate that fetal AED exposure may affect early neonatal neurologic status and several features of early cortical activity. The findings suggest that interference of activity-dependent network development may be a possible mechanism to explain the link from fetal AED exposure to later neurocognitive sequelae.
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