No neurodevelopmental effects of foetal antiseizure medication

Children born to women taking anti-seizure medication during pregnancy either as monotherapy (lamotrigine [LTG] or levetiracetam [LEV]) or polytherapy (LTG+LEV) have no developmental delays at the age of 3. This was found in the prospective, multicentre Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD) study.

“Having a seizure during pregnancy may not only harm the mother but possibly the baby as well, so seizure control is an important part of prenatal care,” said study author Dr Kimford Meador (Stanford University, CA, USA). “While the risks for some medications are known, and careful planning can result in healthy pregnancies, there are some newer medications for which the longer-term effects are still not fully known.”

The MONEAD study (NCT01730170) enrolled women with epilepsy and otherwise healthy women during pregnancy [1]. The primary outcome for children at age 3 was a Verbal Index score, calculated by averaging scores on a series of cognitive and developmental tests that measured skills such as vocabulary, listening comprehension, number recall, and pattern recognition. At enrolment, 74% of pregnant women with epilepsy were on monotherapy, primarily lamotrigine (43%) or levetiracetam (37%). Lamotrigine plus levetiracetam was the most prevalent polytherapy (44%).

The current preliminary analysis assessed 275 children from women with epilepsy and 77 children of healthy women. Results showed that the children of women with epilepsy had similar Verbal Index scores (LS mean 103.4; 95% CI 102.1–104.6) compared with children of healthy women (LS mean 102.7; 95% CI 100.2–105.1). In addition, there were no developmental differences between children of women with epilepsy and healthy women that could be linked to the different levels of antiseizure medications in mothers’ blood samples (n=251) during the third trimester (adjusted parameter estimate -1.2 [-6.2 to 3.8]).

1. Meador K, et al. Fetal Antiseizure Medication Effects on Neuropsychological Outcomes at Age 3 Years in the MONEAD Study. S1.001, AAN 2021 Virtual Congress, 17-22 April.

Copyright ©2021 Medicom Medical Publishers

© 2023 The Author(s). Published by Medicom Medical Publishers.
User license: Creative Commons Attribution – NonCommercial (CC BY-NC 4.0)

Posted on 16 June, 2021