Child development following in utero exposure : a comparison of novel and established antiepileptic drug treatment

• Main Author: Shallcross, Rebekah
• Published: University of Liverpool 2012
• Subjects: 616.853061
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.569778

Research regarding child outcome following in utero exposure to antiepileptic drugs, has documented increased risks for later developmental delay, cognitive impairment and associated language difficulties. Research regarding malformation data has utilised pregnancy and epilepsy registers in order to document the relative risks associated with individual antiepileptic drug exposure, yet pregnancy and epilepsy registers have not been widely utilised in the investigation of child cognitive development. The current research aims to document the developmental abilities of children born to women with epilepsy exposed to the novel antiepileptic drug Levetiracetam (n=110) and the established antiepileptic drug Sodium Valproate (n=86), utilising the U.K.Epilepsy and Pregnancy Register. A control group of children born to women without epilepsy, not taking medication during pregnancy, previously assessed by the Liverpool and Manchester Neurodevelopment Group-was also utilised for comparison (n=232). Children were assessed at either 0-24 months of age or 36-54 months of age. Tests of child development and language abilities, as well as parental report questionnaires pertaining to neurodevelopmental disorders, were administered. Children exposed in utero to Levetiracetam were not found to differ from control children on any measures administered. Linear regression analysis revealed Sodium Valproate exposure to be predictive of poorer overall developmental abilities for children between 0-24 months of age. Further, for children 36-54 months of age, linear regression analysis revealed Sodium Valproate exposure to be predictive of poorer gross locomotor skills, comprehension oflanguage abilities and expressive language abilities. No significant differences were found between any of the groups in regards to parental report pertaining to features of neurodevelopmental disorder. Pregnancy guidelines and preconception counselling information for women with epilepsy should take into account the findings of the current thesis, when deciding upon anti epileptic drug treatment, so that informed decisions can be made by women with epilepsy in conjunction with their healthcare professionals. The current research was sponsored by UCR