Document Detail

Early child development and exposure to antiepileptic drugs prenatally and through breastfeeding: a prospective cohort study on children of women with epilepsy.
MedLine Citation:
PMID:  24061295     Owner:  NLM     Status:  MEDLINE    
IMPORTANCE: Exposure to antiepileptic drugs during pregnancy is associated with adverse effects on psychomotor development.
OBJECTIVES: To determine whether signs of impaired development appear already during the first months of life in children exposed prenatally to antiepileptic drugs, and to explore potential adverse effects of antiepileptic drug exposure through breastfeeding.
DESIGN, SETTING, AND PARTICIPANTS: Mothers at 13 to 17 weeks of pregnancy were recruited in the population-based, prospective Norwegian Mother and Child Cohort Study from 1999 to 2009. The mothers reported on their child's motor and social skills, language, and behavior using items from standardized screening tools at 6 months (n = 78,744), 18 months (n = 61,351), and 36 months (n = 44,147) of age. The mothers also provided detailed information on breastfeeding during the first year. MAIN OUTCOMES AND MEASURES The risk of adverse development in children according to maternal or paternal epilepsy was estimated as the odds ratio with corresponding 95% confidence interval, adjusted for maternal age, parity, education, smoking, breastfeeding, depression/anxiety, folate supplementation, and congenital malformation in the child.
RESULTS: At age 6 months, infants of mothers using antiepileptic drugs (n = 223) had a higher risk of impaired fine motor skills compared with the reference group (11.5% vs 4.8%, respectively; odds ratio = 2.1; 95% CI, 1.3-3.2). Use of multiple antiepileptic drugs compared with the reference group was associated with adverse outcome for both fine motor skills (25.0% vs 4.8%, respectively; odds ratio = 4.3; 95% CI, 2.0-9.1) and social skills (22.5% vs 10.2%, respectively; odds ratio = 2.6; 95% CI, 1.2-5.5). Continuous breastfeeding in children of women using antiepileptic drugs was associated with less impaired development at ages 6 and 18 months compared with those with no breastfeeding or breastfeeding for less than 6 months. At 36 months, prenatal antiepileptic drug exposure was associated with adverse development regardless of breastfeeding status during the first year. Children of women with epilepsy who did not use antiepileptic drugs and children of fathers with epilepsy had normal development at 6 months.
CONCLUSIONS AND RELEVANCE: Prenatal exposure to antiepileptic drugs was associated with impaired fine motor skills already at age 6 months, especially when the child was exposed to multiple drugs. There were no harmful effects of breastfeeding. Women with epilepsy should be encouraged to breastfeed their children irrespective of antiepileptic drug treatment.
Gyri Veiby; Bernt A Engelsen; Nils Erik Gilhus
Related Documents :
3491795 - Barbadian adolescents' knowledge of, and attitudes toward, drugs: an exploratory study.
2105785 - Knowledge and experience of young people regarding drug abuse, 1969-89.
8827655 - Vietnam combat exposure and recent drug use: a national study.
24242975 - Interpretation of drug label instructions: a study among four immigrants groups in the ...
24899225 - Phase ii drugs that target cholinergic receptors for the treatment of overactive bladder.
19517075 - Disposable bioreactors: maturation into pharmaceutical glycoprotein manufacturing.
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  JAMA neurology     Volume:  70     ISSN:  2168-6157     ISO Abbreviation:  JAMA Neurol     Publication Date:  2013 Nov 
Date Detail:
Created Date:  2013-11-12     Completed Date:  2013-12-30     Revised Date:  2014-05-07    
Medline Journal Info:
Nlm Unique ID:  101589536     Medline TA:  JAMA Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1367-74     Citation Subset:  AIM; IM    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Age Factors
Anticonvulsants / adverse effects*
Breast Feeding / adverse effects*
Child, Preschool
Cohort Studies
Community Health Planning
Developmental Disabilities / chemically induced*
Epilepsy / drug therapy
Odds Ratio
Parent-Child Relations
Prenatal Exposure Delayed Effects / chemically induced*
Retrospective Studies
Grant Support
Reg. No./Substance:
Comment In:
JAMA. 2014 May 7;311(17):1797-8   [PMID:  24794373 ]
JAMA Neurol. 2013 Nov;70(11):1357-8   [PMID:  24061233 ]
Nat Rev Neurol. 2014 Jan;10(1):11-2   [PMID:  24323050 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Evaluation of the effect of respiratory and anatomical variables on a Fourier technique for markerle...
Next Document:  Probing the Temperature Unfolding of a Variety of DNA Secondary Structures Using the Fluorescence Pr...