Neurodevelopmental Outcomes in Children with Prenatal Exposure to Antiepileptic Drugs: A Systematic Review
A systematic review examines neurodevelopmental outcomes in children prenatally exposed to antiepileptic drugs.
Essential Reads: Neurodevelopmental Outcomes in Children with Prenatal Exposure to Antiepileptic Drugs
There is a growing body of literature to indicate that exposure to certain antiepileptic drugs, most notably valproic acid (VPA, Depakote) during critical periods of development may be associated with long-lasting neurodevelopmental deficits.
Prenatal Antiepileptic Exposure Increases Risk for Malformations: Does High-Dose Folic Acid Reduce Risk?
The CDC, the U.S. Public Health Service, and the American College of Obstetricians and Gynecologists (ACOG) all recommend that every woman of reproductive age get 400 micrograms (400 mcg) or 0.4 milligrams of folic acid [...]
Cognitive Development in Children Exposed to Levetiracetam (Keppra)
An increasing number of reproductive age women now take newer anticonvulsants for the treatment of mood and anxiety disorders; however, information regarding the reproductive safety of these medications is limited. A recent study has evaluated the cognitive and language development of children born to women with epilepsy exposed in utero to levetiracetam (LEV, Keppra) or sodium valproate (VPA, Depakote), as compared to control children born to women without epilepsy not taking medication during pregnancy.
Valproic Acid and the Risk of Major Malformations
Previous studies have indicated that infants exposed to valproic acid in pregnancy are at increased risk for a range of malformations, including neural tube defects. While these studies have shown an association between valproic acid and various malformations, they have been limited in their ability to quantify the risk of certain, less common malformations. To do this, large population-based case–control studies are more appropriate.
Anticonvulsants During Pregnancy in Women with Bipolar Disorder
Unfortunately the mood stabilizers most commonly used to treat bipolar disorder (including lithium and valproic acid) can increase the risk of certain types of congenital malformations in children exposed to these medications during the first trimester of pregnancy. For women who need a mood stabilizer during pregnancy, lithium is the safest option; however, when used during the first trimester, it carries a 0.1% risk of a cardiac malformation called Ebstein's anomaly. Although this is a potentially serious complication, it is important to keep in mind that the risk of malformation is relatively small.