Teens of epileptic mothers lag academically
Teenagers born to women who took two or more epilepsy drugs while pregnant fare worse in school than peers with no prenatal exposure to these medications.
The researchers identified women with epilepsy who gave birth between 1973 and 1986, as well as those who used anti-epileptic drugs during pregnancy and then obtained records of children's school performance from a registry that provides grades for all students leaving school at 16 years, the age that mandatory education ends in Sweden. The researchers identified 1,235 children born to epileptic mothers. Of those, 641 children were exposed to one anti-epileptic drug and 429 to two or more; 165 children had no known exposure to the medications. The researchers then compared these children's school performance to that of all other children born in Sweden (more than 1.3 million).
Those exposed to more than one anti-epileptic drug in the womb were less likely to get a final grade than those in the general population. Not receiving a final grade meant not attending general school because of mental deficits. While those exposed to only one anti-seizure medication did not show the same risk, they were less likely to pass with excellence. This may be the result of the influence of the anti-epileptic drug during fetal life, but it may also be the effect of factors related to epilepsy, such as genetic factors, social factors and the effect of the mother's seizures. Anti-epileptic medications include valproic acid, phenytoin (such as Dilantin and Phenytek) and carbamazepine (such as Tegretol and Carbatrol). The study noted that compared to other anti-epileptic drugs, valproic acid during pregnancy seemed to have a stronger negative influence on cognitive skills in the children. However, the study could not draw specific conclusions about valproic acid, since very few of the children studied were exposed to it.
The results suggest that exposure to several anti-epileptic drugs in the womb may have a negative effect on a child's neurological development. The findings support earlier research that linked prenatal exposure to epilepsy drugs, particularly valproic acid, to negative effects on a child's ability to process information, solve problems and make decisions.
The researchers recommend that pregnant women should avoid taking more than one anti-seizure drug in pregnancy, if possible.
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