Children's neurodevelopment not affected by new epilepsy drugs used during pregnancy

Press release

Wednesday, November 27, 2024

An NIH-funded study clarifies safety concerns regarding two commonly used anticonvulsant drugs, lamotrigine (levetiracetam) and levetiracetam.

Children of mothers who used certain anticonvulsant medications during pregnancy do not experience worse neurodevelopmental outcomes at age 6, according to a study funded by the National Institutes of Health for many years. This study was first published in JAMA Neurology.

Read moreWhen brains come into harmony

Dr. Adam Hartman is the program director of the NIH's National Institute of Neurological Disorders and Stroke. A major component of this study was the correlation of children's cognitive abilities with maternal blood levels. This opens up the possibility of future research and could inform better dosing strategies.

Treatment Epilepsy It is difficult to take anticonvulsants during pregnancy, especially older medications like valproate. These medications are associated with serious cognitive and birth defects in infants, such as autism and lower IQ. Newer, commonly used anticonvulsant medications are considered safe. However, little is known about their effects on cognition after in utero exposure.

The researchers assessed the language skills of 387 6-year-old children (298 born to women with epilepsy who were taking anticonvulsant medications). The children were assessed on various verbal skills, such as vocabulary and the ability to match spoken words to pictures. The children's language skills did not differ between women taking the medication and those not taking it. The majority of the women took lamotrigine or levetiracetam during and after pregnancy.

This study is important because test results are more accurate when a child is assessed at age 6, especially at age 2. The results of this study are predictive of cognitive abilities in adulthood and have a measurable effect on student performance.

Finding the safest and most effective doses of anticonvulsant medications during pregnancy can be difficult. Risks also vary depending on the medication. Previous studies The same team of researchers showed that high doses of levetiracetam can lead to worsening cognitive outcomes in children aged 2 and 3 years, as well as a decline in adaptive functions at 4.5 years. However, the results for the overall population were still positive.

The doctor said it is important to find the right balance between ensuring there is enough medication on board to protect both the mother and the developing child from seizures, without putting the child at risk.

Even at high doses, the study found that folate consumption during the first 12 weeks of pregnancy was linked to better behavioral and cognitive outcomes. Folate, an essential vitamin that helps prevent brain and spinal defects in the developing fetus, is a nutrient. The results were the same for women with and without epilepsy. High doses, up to or above 4 mg per day, did not cause adverse effects. This contrasts with previous studies that found high doses of folic acid were associated with long-term risk.

The MONEAD (Maternal Outcomes & Neurodevelopmental effects of Antiepileptic drugs) study is a long-term, prospective study that examined the impact of antiepileptic drugs on pregnant women with epilepsy and their babies from birth to age six. The study was conducted at 20 different medical centers across the United States. It was led by Dr. Meador and Dr. Page Pennell, chair of neurology at the University of Pittsburgh.

Other analyses found no evidence of adverse effects on breastfeeding from antiepileptic drugs. Researchers say further studies are needed to determine the risks of antiepileptic drugs and high doses of folate, as well as less commonly used drugs.

The NINDS, the NIH and the Eunice Kennedy Shriver National Institute of Child Health and Human Development U01NS038455 and MONEAD (U01NS050659) and was part of the study.NCT01730170).

The National Institute of Neurological Disorders and Stroke: NINDS NINDS is the leading funding agency for brain and nervous system research in the United States. NINDS's mission is to develop fundamental knowledge about the nervous system, brain, and other organs and to use this knowledge to reduce the burden of neurological disease.

The National Institutes of Health: The NIH is the medical research agency of the U.S. Department of Health and Human Services. It comprises 27 institutes and centers. The NIH, the nation's medical research agency, is the primary federal agency conducting and supporting basic, translational, clinical, and other types of medical research. It also studies the causes, treatments, and cures for common and rare diseases. Visit the NIH for more information about its programs and services. www.nih.gov.

NIH…Transforming discovery into healthcare^(r)

###