RT Journal Article
SR Electronic
T1 The prevalence of neurodevelopmental disorders in children prenatally exposed to antiepileptic drugs
JF Journal of Neurology, Neurosurgery & Psychiatry
JO J Neurol Neurosurg Psychiatry
FD BMJ Publishing Group Ltd
SP 637
OP 643
DO 10.1136/jnnp-2012-304270
VO 84
IS 6
A1 Bromley, Rebecca Louise
A1 Mawer, George E
A1 Briggs, Maria
A1 Cheyne, Christopher
A1 Clayton-Smith, Jill
A1 García-Fiñana, Marta
A1 Kneen, Rachel
A1 Lucas, Sam B
A1 Shallcross, Rebekah
A1 Baker, Gus A
A1 ,
YR 2013
UL http://jnnp.bmj.com/content/84/6/637.abstract
AB The aim of this study was to compare the prevalence of diagnosed neurodevelopmental disorders in children exposed, in utero, to different antiepileptic drug treatments. A prospective cohort of women with epilepsy and a control group of women without epilepsy were recruited from antenatal clinics. The children of this cohort were followed longitudinally until 6 years of age (n=415). Diagnosis of a neurodevelopmental disorder was made independently of the research team. Multiple logistic regression analysis revealed an increase in risk of neurodevelopmental disorders in children exposed to monotherapy sodium valproate (VPA) (6/50, 12.0%; aOR 6.05, 95%CI 1.65 to 24.53, p=0.007) and in those exposed to polytherapy with sodium VPA (3/20, 15.0%; aOR 9.97, 95% CI 1.82 to 49.40, p=0.005) compared with control children (4/214; 1.87%). Autistic spectrum disorder was the most frequent diagnosis. No significant increase was found among children exposed to carbamazepine (1/50) or lamotrigine (2/30). An accumulation of evidence demonstrates that the risks associated with prenatal sodium VPA exposure include an increased prevalence of neurodevelopmental disorders. Whether such disorders are discrete or represent the severe end of a continuum of altered neurodevelopmental functioning requires further investigation. Replication and extension of this research is required to investigate the mechanism(s) underpinning the relationship. Finally, the increased likelihood of neurodevelopmental disorders should be communicated to women for whom sodium VPA is a treatment option.