Neurodevelopment of babies born to mothers with epilepsy: A prospective observational cohort study

Abstract

Objective: Despite widespread monotherapy use of lamotrigine or levetiracetam during pregnancy, prospectively collected, blinded child development data are still limited. The NaME (Neurodevelopment of Babies Born to Mothers With Epilepsy) Study prospectively recruited a new cohort of women with epilepsy and their offspring for longitudinal follow-up. Methods: Pregnant women of <21 weeks gestation (n = 401) were recruited from 21 hospitals in the UK. Data collection occurred during pregnancy (recruitment, trimester 3) and at 12 and 24 months of age. The primary outcome was blinded assessment of infant cognitive, language, and motor development on the Bayley Scales of Infant and Toddler Development (3rd edition) at 24 months of age with supplementary parent reporting on the Vinelands Adaptive Behavior Scales (2nd edition). Results: There were 394 live births, with 277 children (70%) completing the Bayley assessment at 24 months. There was no evidence of an association of prenatal exposure to monotherapy lamotrigine (−.74, SE = 2.9, 95% confidence interval [CI] = −6.5 to 5.0, p =.80) or levetiracetam (−1.57, SE = 3.1, 95% CI = −4.6 to 7.7, p =.62) with poorer infant cognition, following adjustment for other maternal and child factors in comparison to nonexposed children. Similar results were observed for language and motor scores. There was no evidence of an association between increasing doses of either lamotrigine or levetiracetam. Nor was there evidence that higher dose folic acid supplementation (≥5 mg/day) or convulsive seizure exposure was associated with child development scores. Continued infant exposure to antiseizure medications through breast milk was not associated with poorer outcomes, but the number of women breastfeeding beyond 3 months was low. Significance: These data are reassuring for infant development following in utero exposure to monotherapy lamotrigine or levetiracetam, but child development is dynamic, and future follow-up is required to rule out later emerging effects.

Publication DOI: https://doi.org/10.1111/epi.17709
Divisions: College of Health & Life Sciences > School of Psychology
Funding Information: This study is funded by the NIHR Post Doctoral Fellowship Scheme (NIHR PDF‐2013‐06‐041). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. R.L.B. has served on an expert advis
Additional Information: Copyright © 2023 The Authors. Epilepsia published by Wiley Periodicals LLC on behalf of International League Against Epilepsy. This is an open access article under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited. Funding Information: This study is funded by the NIHR Post Doctoral Fellowship Scheme (NIHR PDF‐2013‐06‐041).
Uncontrolled Keywords: antiseizure medication,development,epilepsy,pharmacovigilance,pregnancy,Neurology,Clinical Neurology
Publication ISSN: 1528-1167
Last Modified: 07 Oct 2024 07:50
Date Deposited: 10 Aug 2023 17:58
Full Text Link:
Related URLs: http://www.scop ... tnerID=8YFLogxK (Scopus URL)
https://onlinel ... .1111/epi.17709 (Publisher URL)
PURE Output Type: Article
Published Date: 2023-09
Published Online Date: 2023-07-16
Accepted Date: 2023-06-29
Authors: Bromley, Rebecca
Bullen, Philip
Campbell, Ellen
Craig, John
Ingham, Amy
Irwin, Beth
Jackson, Cerain
Kelly, Teresa
Morrow, James
Rushton, Sarah
García-Fiñana, Marta
Hughes, David M.
Winterbottom, Janine
Wood, Amanda (ORCID Profile 0000-0002-1537-6858)
Yates, Laura M.
Clayton-Smith, Jill
, the NaME Study Group

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