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Review
. 2021;19(11):1825-1834.
doi: 10.2174/1570159X19666210716111814.

Neurodevelopment Following Exposure to Antiseizure Medications in Utero: A Review

Rebecca L Bromley  1 , Matthew Bluett-Duncan  1
Affiliations
Review

Neurodevelopment Following Exposure to Antiseizure Medications in Utero: A Review

Rebecca L Bromley et al. Curr Neuropharmacol. 2021.

Abstract

Exposure in the womb to antiseizure medications and their potential impact on the brain of the developing child has long been researched. Despite this long period of interest, this review highlights that above the well-known risks associated with valproate exposure, there are more data required for conclusions regarding all other antiseizure medications. Limited experience with phenytoin and phenobarbital in monotherapy makes clearly defining the risk to later child postnatal functioning difficult, although the evidence of an impact is stronger for phenobarbital than for phenytoin. The widely prescribed lamotrigine is limited in its investigation in comparison to unexposed control children, and whilst it has been demonstrated to carry a lower risk than valproate for certain outcomes, whether it is associated with a more moderate impact on wider aspects of neurodevelopmental functioning is still to be understood. Data for levetiracetam, topiramate and oxcarbazepine are too limited to confidently draw conclusions for most neurodevelopmental outcomes. This slow accumulation of evidence impacts on the safest use of medications in pregnancy and makes counseling women regarding the risks and benefits of specific antiseizure medications difficult. Improved focus, funding, and research methodologies are urgently needed.

Keywords: Antiseizure medications; antiepileptic drugs; child development; epilepsy; neurodevelopment; pregnancy; teratology..

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References

    1. Vorhees C. 1986. Principles of behavioral teratology .
    1. Adams J., Barone S., Jr, LaMantia A., Philen R., Rice D.C., Spear L., Susser E. Workshop to identify critical windows of exposure for children’s health: Neurobehavioral work group summary. Environ. Health Perspect. 2000;108(Suppl. 3):535–544. doi: 10.1289/ehp.00108s3535. - DOI - PMC - PubMed
    1. Rice D., Barone S., Jr Critical periods of vulnerability for the developing nervous system: evidence from humans and animal models. Environ. Health Perspect. 2000;108(Suppl. 3):511–533. - PMC - PubMed
    1. Speidel B.D., Meadow S.R. Maternal epilepsy and abnormalities of the fetus and newborn. Lancet. 1972;2(7782):839–843. doi: 10.1016/S0140-6736(72)92209-X. - DOI - PubMed
    1. Bromley R., Weston J., Adab N., Greenhalgh J., Sanniti A., McKay A.J., Tudur S.C., Marson A.G. Treatment for epilepsy in pregnancy: Neurodevelopmental outcomes in the child. Cochrane Database Syst. Rev. 2014;10(10):CD010236. doi: 10.1002/14651858.CD010236.pub2. - DOI - PMC - PubMed