Exposure to Antiseizure Medication Inutero May Lead to Neurodevelopmental Risks in Children: Study Finds
Children born to mothers who take antiseizure medications to manage seizures and psychiatric conditions during pregnancy may face increased risks of neurodevelopmental conditions, according to new data from researchers at Drexel’s Dornsife School of Public Health. The findings were published in the journal Nature Communications.
The current work -- using data from more than three million children from the United Kingdom and Sweden, including 17,495 who were exposed to antiseizure medications during pregnancy -- found that children exposed to the antiseizure drug lamotrigine in utero were at no additional risk for autism or intellectual disability compared with those exposed to other antiseizure medications. However, children exposed to valproate, topiramate, and carbamazepine were linked to specific neurodevelopmental issues. However, the absolute risk of neurodevelopmental outcomes in offspring is low, the researchers caution, regardless of antiseizure drug regimen. Compared to children unexposed to antiseizure medications, those exposed to the drug topiramate during pregnancy were 2.5 times more likely to be diagnosed with intellectual disability, which raises their risk to 2.1% by age 12. In comparison with other drugs available, the authors found very little data suggesting that the drug lamotrigine in pregnancy increases the risk of neurodevelopmental issues in offspring.
According to the researchers, the data does not argue against use of antiseizure medications in patients who benefit, but rather encourages these patients to have a conversation with their doctor to determine if their course of treatment is most appropriate for them.
The study utilized data on drug prescriptions in the United Kingdom, and dispensation and self-reported data on drug use in Sweden, as well as electronic health records data for diagnoses. The authors conducted a sibling analysis to help minimize the influence of other factors, such as severity of diagnosis and underlying genetics, that may influence the results.
Reference: Madley-Dowd, P., Ahlqvist, V.H., Forbes, H. et al. Antiseizure medication use during pregnancy and children’s neurodevelopmental outcomes. Nat Commun 15, 9640 (2024). https://doi.org/10.1038/s41467-024-53813-1
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