Summary: According to research, some antiseizure medications taken while pregnant may raise children’s risk of developing developmental conditions. Medicines like valproate, topiramate, and carbamazepine were associated with certain risks, including autism and intellectual disability, while lamotrigine was found to create little to no more chance.
The overall risk is still lower despite these findings, and medical professionals should consult with them before making decisions regarding treatment use. In order to strike a balance between pregnancy and child health, the study emphasizes personalized care.
Important Information:
- No higher-risk of developmental issues in the offspring is demonstrated by lamotrigine.
- Valproate and topiramate are linked to higher threats, including philosophical illness.
- Both the mother and the child must be safe, and personalized medical choices are crucial.
Origin: Drexel University
According to new research from academics at Drexel’s Dornsife School of Public Health, parents who take antiseizure drugs to control seizures and medical problems during childbirth may have higher risk of developing developmental problems.
The present study found that children exposed to the antiseizure medicine lamotrigine in utero were not at higher risk for dementia or intellectual impairment than those exposed to various antiseizure drugs, using information from more than three million babies from the UK and Sweden, including 17, 495 of those who were exposed to it while pregnant.
However, children exposed to valproate, topiramate, and carbamazepine were linked to specific neurodevelopmental issues.
The findings were published this month in the journal , Nature Communications.
However, the absolute risk of neurodevelopmental outcomes in offspring is low, the researchers caution, regardless of antiseizure drug regimen. Those exposed to the drug topiramate during pregnancy were 2.5 times more likely than children who were not subject to antiseizure medications, increasing their risk by 2.1 % by age 12 by 2.5 times.  ,
The authors found very little data that suggested the use of lamotrigine during pregnancy increases the risk of neurodevelopmental issues in the offspring in comparison to other drugs.
” Our findings suggest that while certain medications may pose some risk, lamotrigine may be a less risky option” , , said co-senior author , Brian K. Lee, PhD, a professor in the Dornsife School of Public Health.
” Active monitoring of any antiseizure medication is critical to ensure safety and effectiveness, particularly during pregnancy”.
Despite the fact that the birthing parent had an epilepsy diagnosis, this study differs from earlier studies in that it did not find a statistically significant relationship between ADHD in children and levetiracetam.
The research concludes that the data encourages patients to talk to their doctor to determine whether their course of treatment is best for them. It does not, however, oppose the use of antiseizure medications in those who benefit.
” Decisions should be made that are tailored to individual patients”, said co-lead author , Paul Madley-Dowd, PhD, a research fellow at the University of Bristol.  ,
Because using antiseizure medications can harm a person and their offspring, these discussions must always take place with a doctor.
This study supports findings from previous research that link the antiseizure drugs valproate, topiramate, and carbamazepine with neurodevelopmental diagnoses in offspring, such as autism, intellectual disability and ADHD.  ,
Previous studies in smaller populations also link in utero exposure of these drugs with neurodevelopmental outcomes in offspring, such as ones linking topiramate , and intellectual disability, and those associating , valproate and lower IQ.
The study used medical records, data on drug use in Sweden, and dispensation and self-reported data on drug use in the United Kingdom, as well as data on diagnoses in electronic health records. To help reduce the impact of other factors, such as the degree of diagnosis and the underlying genetics, the authors conducted a sibling analysis.
” The link between these drugs and children’s neurodevelopmental outcomes is there, even if the risk is n’t much higher than it is in the unexposed population”, said co-lead author , Viktor H. Ahlqvist, a postdoctoral researcher at Karolinska Institutet.  ,
” If you’re pregnant or trying to become pregnant, and taking one of these medications, it may be worth talking with your physician to make sure you’re taking the best medicine for your needs, while minimizing risk to future children”.
Despite the study’s sizable sample size, the authors claim that patients could gain from additional research into the safety of these medications as the patient landscape changes.
In addition to Lee, Madley-Dowd and Ahlqvist, other authors included co-senior authors Cecilia Magnusson from the Karolinska Institutet and Dheeraj Rai from the University of Bristol, and collaborators from Drexel University, Pennylvania State University, London School of Hygiene and Tropical Medicine, University College London, University of Bristol, and the Karolinska Institutet.
Funding: The study was funded by the National Institutes of Health ( 1R01NS107607 ).
About this research in neuropharmacology and neurodevelopment
Author: Greg Richter
Source: Drexel University
Contact: Greg Richter – Drexel University
Image: The image is credited to Neuroscience News
Original Research: Open access.
” Antiseizure Medication Use During Pregnancy and Children’s Neurodevelopmental Outcomes” by Brian K. Lee et al. Nature Communications
Abstract
Antiseizure Medication Use During Pregnancy and Children’s Neurodevelopmental Outcomes
The teratogenic potential of valproate in pregnancy is well established, however, evidence regarding the long-term safety of other antiseizure medications ( ASMs) during pregnancy remains limited.
Using routinely collected primary care data from the UK and nationwide Swedish registries to create a cohort of 3, 182, 773 children, of which 17, 495 were exposed to ASMs in pregnancy, we show that those exposed to valproate were more likely to receive a diagnosis of autism, intellectual disability, and ADHD, when compared to children not exposed to ASMs.
Additionally, children exposed to topiramate were 2.5 times more likely to be diagnosed with intellectual disability (95 % CI: 1.23–4.98 ), and those exposed to carbamazepine were 1.25 times more likely to be diagnosed with autism (95 % CI: 1.05–1.48 ) and 1.30 times more likely to be diagnosed with intellectual disability (95 % CI: 1.01–1.69 ).
Little evidence existed to support the prenatal developmental diagnosis of children exposed to lamotrigine.
Although more research is required, these findings may lead to the development of safer, more effective treatment options well before conception.
