Cognitive Function after Fetal Exposure to Antiepileptic Drugs

Abstract

To the Editor: Meador et al. (April 16 issue)1 suggest that children who had been exposed to valproate in utero had significantly lower IQ scores than those who had been exposed to other antiepileptic drugs. However, the results of their study should be interpreted with caution. Many factors have a role in the neuropsychological development of children, apart from fetal exposure to antiepileptic drugs. We are not given details of the quality of the home environment, which has been recognized as a key environmental influence on child development.2 The Home Screening Questionnaire (HSQ) is a widely used tool to assess the qualities of the home environment that may influence the development of children,3 such as emotional and verbal responses of the mother and avoidance of restriction and punishment. Although the study by Meador and colleagues included detailed monitoring of multiple potential confounding factors relating to child IQ, the HSQ may be helpful for obtaining more detailed and appropriate assessments of and conclusions about the children at the age of 6 years.