Two Common Antiseizure Medications Do Not Harm Child Neurodevelopment
TUESDAY, Dec. 3, 2024 -- Fetal exposure to two common antiseizure medications (ASMs) does not seem to negatively impact children's neurological development at age 6 years, according to a study published online Nov. 25 in JAMA Neurology.
Kimford J. Meador, M.D., from the Stanford University School of Medicine in Palo Alto, California, and colleagues compared the outcomes of 6-year-old children of women with epilepsy (WWE) versus those of healthy women to assess the association of outcomes to third-trimester ASM exposures. The analysis included 298 children of WWE and 89 children of healthy women.
The researchers found that the two groups of children did not differ on the Verbal Index Score, but there was variance based on the amount of ASM exposure. Lamotrigine showed positive exposure-dependent associations, while levetiracetam showed negative exposure-dependent associations. Across ASMs, exposure-dependent outcomes differed. Three-quarters of WWE (78 percent) were taking lamotrigine or levetiracetam alone or in combination, so assessment of other ASMs was limited. There were positive associations for folate supplementation during the first 12 weeks of pregnancy with cognition and behavior, with no signal for risks at higher folate doses.
"Because all ASMs are potential teratogens, and teratogens act in an exposure-dependent manner, the clinical challenge is to provide a dose sufficiently high to protect the mother and fetus from seizures but at the lowest effective concentration to minimize fetal risks," the authors write.
Several authors disclosed ties to the pharmaceutical industry.
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