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Updated: Oct 18, 2025

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Impact of In Utero Exposure to Antiepileptic Drugs on Neonatal Brain Function

Anton Tokariev1,2, Michael Breakspear3,4, Mari Videman1,5

  • 1Baby Brain Activity Center (BABA), Department of Clinical Neurophysiology, New Children's Hospital, HUS Imaging, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Cerebral Cortex (New York, N.Y. : 1991)
|September 29, 2021
PubMed

Insights

Antiepileptic drugs given during pregnancy can affect a newborn's brain activity during sleep, indicating potential risks to neurodevelopment. Different medications show varying impacts, highlighting drug-specific effects on infant brain health.

Area of Science:

  • Neuroscience
  • Developmental Biology
  • Pharmacology

Background:

  • In utero brain development is crucial for lifelong brain health.
  • Prenatal exposures, including medications, can disrupt normal neurodevelopment.
  • Neonatal sleep patterns are sensitive indicators of brain health.

Purpose of the Study:

  • To investigate the impact of antiepileptic drugs (AEDs) during pregnancy on neonatal cortical activity.
  • To determine if these effects predict later neurodevelopmental outcomes.
  • To differentiate effects of AEDs from maternal epilepsy itself.

Main Methods:

  • Analysis of cortical activity during neonatal sleep in infants exposed to AEDs in utero.
  • Assessment of frequency-specific functional brain networks.
  • Correlation of brain activity patterns with later neurodevelopmental assessments.

Main Results:

  • AED exposure in utero altered cortical activity during neonatal sleep.
  • Observed effects were network-specific and varied between different AEDs.
  • These alterations were prognostic for neurodevelopmental trajectories.
  • Effects were attributed to AEDs, not maternal epilepsy.

Conclusions:

  • Neonatal sleep-based brain activity metrics are sensitive to prenatal AED exposure.
  • These metrics offer translatable bedside tools for assessing neurodevelopmental risk.
  • Findings suggest specific AEDs may pose greater neurodevelopmental risks than others.

Keywords:
antiepileptic drugbrain networkinfantneurodevelopmentneurology

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