In Utero Effects of AEDs.

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Long-term Health and Neurodevelopment in Children Exposed to Antiepileptic Drugs Before Birth Dean JC, Hailey H, Moore SJ, Lloyd DJ, Turnpenny PD, Little J. J Med Genet 2002;39:251–259 Objective To investigate the frequency of neonatal and later childhood morbidity in children exposed to antiepileptic drugs in utero. Design Retrospective population-based study. SETTING: Population of the Grampian region of Scotland. Participants Mothers taking antiepileptic drugs in pregnancy between 1976 and 2000 were ascertained from hospital obstetric records, and 149 (58% of those eligible) took part. They had 293 children whose health and neurodevelopment were assessed. Main outcome measures: Frequencies of neonatal withdrawal, congenital malformations, childhood-onset medical problems, developmental delay, and behaviour disorders. Results Neonatal withdrawal was seen in 20% of those exposed to antiepileptic drugs (AEDs). Congenital malformations occurred in 14% of exposed pregnancies, compared with 5% of nonexposed sibs, and developmental delay in 24% of exposed children, compared with 11% of nonexposed sibs. After excluding cases with a family history of developmental delay, 19% of exposed children and 3% of nonexposed sibs had developmental delay, 31% of exposed children had either major malformations or developmental delay, 52% of exposed children had facial dysmorphism compared with 25% of those not exposed, 31% of exposed children had childhood medical problems (13% of nonexposed sibs), and 20% had behaviour disorders (5% of nonexposed). Conclusion Prenatal AED exposure in the setting of maternal epilepsy is associated with developmental delay and later childhood morbidity in addition to congenital malformation.