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Neurobehavioral Outcomes of Children with Antenatal Exposure to Antiseizure Medications
Deepa Bhaskaran1, Sanjeev Thomas2, Liss Maria Scaria3
1Department of Developmental Pediatrics, Child Development Centre, Thiruvananthapuram Medical College, Thiruvananthapuram, 695 011, Kerala, India. deepa.children@hotmail.com.
Insights
Antiepileptic drug exposure during pregnancy was linked to speech delays in young children. This finding highlights potential long-term challenges for children with early language difficulties.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Pharmacology
Background:
- Epilepsy affects women of childbearing age.
- Antiepileptic medications (ASMs) are often necessary during pregnancy.
- The impact of prenatal ASM exposure on child development requires thorough investigation.
Purpose of the Study:
- To assess the developmental and behavioral effects of maternal antiepileptic drug use during pregnancy on young children.
- To identify specific language or behavioral outcomes associated with prenatal exposure to ASMs.
Main Methods:
- A cohort of 98 children aged 1.5-2.5 years exposed to ASMs in utero was compared to a control group.
- Developmental assessments utilized the Developmental Assessment Scale for Indian Infants (DASII) and Receptive-Expressive Emergent Language Scale (REELS).
- Child Behavior Checklist was used to evaluate behavioral outcomes.
Main Results:
- Children exposed to ASMs showed a significant delay in expressive language skills (OR 2.539).
- Polytherapy, specifically with clobazam, was associated with significant delays in both expressive (OR 6.83) and receptive (OR 7.333) language skills.
- No significant differences were observed in motor, mental, or behavioral outcomes between groups.
Conclusions:
- Prenatal exposure to antiepileptic medications is associated with a significant risk of speech and language delays in early childhood.
- These language delays may have long-term implications for mental health, social adjustment, and academic achievement.
- Further research into the specific effects of different ASMs and polytherapy regimens is warranted.
Objectives:
To evaluate the effect of antiepileptic medications prescribed to mothers during pregnancy on the development and behavior of children.
Methods:
From the Kerala Registry of Epilepsy and Pregnancy, 98 children between the ages of 1½ to 2½ y were consecutively chosen. Children of mothers who did not have epilepsy during pregnancy and not exposed to antiseizure medications (ASMs) antenatally were selected as comparator group. Developmental assessment of the children was performed using Developmental Assessment Scale for Indian Infants (DASII) and Receptive-Expressive Emergent Language Scale (REELS). Behavior outcomes were assessed using Child Behavior Checklist.
Results:
A significant delay in expressive language skills was seen in children exposed to antiseizure medication with an odds ratio of 2.539 (95% CI 1.10, 5.85, P = 0.026). A delay in expressive language skills was seen in polytherapy with clobazam (odds ratio 6.83; 95% CI 2.17, 21.56, P < 0.001). Also, delay was seen in receptive language skills in the same polytherapy group (odds ratio of 7.333; 95% CI 2.16, 24.92, P < 0.001). There were no statistically significant differences between study and comparative groups in motor and mental quotient domains and behavioral outcomes.
Conclusions:
The finding of speech delay in children exposed to ASMs is significant since individuals with a history of childhood speech or language disorders may experience long-term difficulties in mental health, social well-being, and academic outcomes.
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