Late Pregnancy Antiseizure Medication Exposure and Offspring Neurodevelopmental Risk: A Multi-Child Cohort Study
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View abstract on PubMed
Summary
This summary is machine-generated.Prenatal exposure to antiseizure medications (ASMs) is linked to a higher risk of neurodevelopmental disorders (NDDs) in children. This association highlights the need for careful consideration of ASM use during pregnancy.
Area Of Science
- Neuroscience
- Developmental Pediatrics
- Pharmacology
Background
- Antiseizure medication (ASM) use during pregnancy has risen, yet its impact on offspring neurodevelopment remains debated.
- Existing evidence on prenatal ASM exposure and neurodevelopmental disorders (NDDs) is inconsistent.
- This study addresses the need for clearer data on the association between prenatal ASM exposure and NDDs.
Purpose Of The Study
- To evaluate the association between prenatal exposure to antiseizure medications (ASMs) and the risk of neurodevelopmental disorders (NDDs) in children.
- To analyze data from large, population-based mother-child cohorts in Canada and the United States.
- To provide evidence for informed decision-making regarding ASM use in pregnant individuals.
Main Methods
- Analysis of 5 population-based cohorts (Canadian Mother-Child Cohort [CAMCCO] and AM-PREGNANT).
- ASM exposure defined by maternal prescription fills within 60 days before birth.
- NDDs identified using validated algorithms based on ICD-9/10 codes; Cox proportional hazards models and meta-analysis were employed.
Main Results
- Prenatal ASM exposure in 0.47% of 2,910,206 children was associated with a 29% increased risk of NDDs (pooled-adjusted hazard ratio [p-aHR]: 1.29).
- Specific ASMs showed varied risks: carbamazepine (p-aHR: 1.50), clonazepam (p-aHR: 1.22), topiramate (p-aHR: 1.56), and valproic acid (p-aHR: 1.38).
- Polytherapy showed a trend towards higher risk than monotherapy, but this was not statistically significant.
Conclusions
- Prenatal exposure to certain ASMs is consistently linked to elevated risks of NDDs in offspring.
- Findings underscore the importance of individualized risk-benefit assessments for ASM use during pregnancy.
- Careful decision-making is crucial to mitigate potential neurodevelopmental risks in children exposed to ASMs prenatally.
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