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Exposure to antiepileptic drugs in pregnancy: The need for a family factor framework
Yfke Huber-Mollema1, Loretta van Iterson2, Josemir W Sander3
1Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, the Netherlands; Research Institute of Child Development and Education, University of Amsterdam, the Netherlands.
Insights
Children exposed to antiepileptic drugs (AEDs) in utero face developmental risks. Family factors also impact child development, necessitating further research into their interplay with AED exposure.
Area of Science:
- Developmental neuroscience
- Family systems psychology
- Pharmacology
Background:
- In utero exposure to antiepileptic drugs (AEDs) poses risks for child developmental problems.
- Maternal epilepsy and family dynamics can also influence a child's development.
- Existing research has not fully explored the impact of family factors on children exposed to AEDs.
Purpose of the Study:
- To review the associations between family factors and developmental outcomes in children with in utero AED exposure.
- To explore the role of maternal epilepsy and family system dynamics.
- To identify gaps in research regarding family factors and neurodevelopmental outcomes.
Main Methods:
- Conducted a narrative review of literature.
- Searched databases including MEDLINE, Embase, Google Scholar, and PsycINFO.
- Utilized the ABCX model as a framework to analyze family factors.
Main Results:
- Limited studies have investigated the impact of family factors on children exposed to AEDs.
- Mothers with epilepsy report increased parenting stress and challenges in self-care and child-rearing.
- A significant gap exists in understanding how family factors influence neurocognitive and behavioral development.
Conclusions:
- Further research is needed to identify specific family factors associated with child development alongside AED exposure.
- The interaction between AED effects and family factors requires investigation.
- Study designs incorporating family factors are encouraged due to the vulnerability of children and the impact of epilepsy on family dynamics.
Purpose:
Children exposed to antiepileptic drugs (AEDs) in utero are at risk for developmental problems. Maternal epilepsy, its impact on the family system, and other family factors may also contribute. We reviewed the possible associations between family factors and developmental outcome in children who had been exposed to AED during pregnancy.
Methods:
We conducted a narrative review and searched MEDLINE, Embase, Google Scholar, and PsycINFO on the following terms: in utero exposure, pregnancy outcome, and AEDs. A family factor framework (the ABCX model) served as the basis to review distinct family factors in children who were exposed to AEDs in pregnancy.
Results:
Few studies have investigated these factors. Mothers with epilepsy have problems caring for themselves and for the child and experience more parenting stress. There is a paucity of studies of the possible impact of family factors on the neurocognitive and behavioral development of children of mothers with epilepsy.
Discussion:
Further work is required to ascertain which family factors are associated with child development in addition to the effects of AED exposure and their potential interaction. As epilepsy may have considerable impact on intrafamily factors and as children are especially vulnerable to such effects, study designs incorporating family factors should be encouraged.
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