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a classroom imageMarch 27 2018

Exposure to anti-epilepsy drugs in the womb has been linked to significantly poorer school test results. 

A study conducted in Wales has looked at the Key Stage 1 results of 440 children born to mothers with epilepsy.” Compared with a matched control group, fewer children with mothers being prescribed sodium valproate during pregnancy achieved the national minimum standard in core subject indicators, with a difference of 12.7%. The differences were 12.1% for mathematics, 10.4% for language, and 12.2% for science.

For mothers who were prescribed multiple dugs for epilepsy, even fewer children achieved the national minimum standards, by about 20%.

The researchers looked at use of carbamazepine, lamotrigine and sodium valproate, either as monotherapy or in combination.

“Mothers being prescribed multiple AEDs [anti-epilepsy drugs] and those being prescribed sodium valproate have children with significantly poorer attainment in national tests at the age of 7,” the said. “In contrast, there was no difference seen in children exposed to carbamazepine, lamotrigine or mothers who did not take drugs during pregnancy.” However, the lamotrigine group was small.

The findings follow the European Medicine Agency endorsement of guidance that valproate is now contraindicated in pregnancy, and that women of child bearing potential taking valproate should be properly advised about pregnancy prevention.

The Welsh study has been published in the Journal of Neurology Neurosurgery & Psychiatry. In a linked commentary, Dr Richard Chin of the University of Edinburgh’s Muir Maxwell Epilepsy Centre, emphasises the importance of a study that is based on population data. He said that this can be used to inform preventive/interventional strategies and help women to better understand the implications of epilepsy treatment while pregnant.

“By providing ‘functional’ outcome data from their study, the authors have now provided information that prospective parents may find readily tangible: it should be included in information given to women with epilepsy prior to pregnancy,” said Dr Chin.

Links:
AS Lacey et al. ‘Educational attainment of children born to mothers with epilepsy’.  Neurol Neurosurg Psychiatry 2018;0:1–5. doi:10.1136/jnnp-2017-317515            
RFM Chin. ‘AEDs or no AEDs during pregnancy? That is the question’. J Neurol Neurosurg Psychiatry 2018 doi:10.1136/jnnp-2017-317924             

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