The DOI matches its Crossref record; 44 of the 44 references it cites were found in a registry or an index.
The longer term outcome of children born to mothers with epilepsy
Open accessAbstract
OBJECTIVES: To determine the prevalence of cognitive delay and possible associated dysmorphic features in children exposed to antiepileptic drugs (AEDs) in utero. DESIGN: Retrospective study of children born to mothers with epilepsy. SETTING: Regional epilepsy clinics in Liverpool and Manchester, UK. PARTICIPANTS: Children aged between 6 months and 16 years born to mothers with epilepsy. MAIN OUTCOME MEASURES: Structured interviews, hospital records, clinical examination, and psychometric tests (Wechsler) were used to assess exposure and intelligence quotient (IQ). Blinded assessment of photographs was used to score children with characteristic dysmorphic features. RESULTS: A total of 249 children aged 6 and over were studied: 41 were exposed to sodium valproate, 52 to carbamazepine, 21 to phenytoin, 49 to polytherapy, and 80 were unexposed. Mean verbal IQ was significantly lower in the valproate group compared to unexposed and other monotherapy groups. Multiple regression analysis showed that both valproate exposure and frequent tonic-clonic seizures in pregnancy were significantly associated with a lower verbal IQ despite adjusting for other confounding factors. There was a significant negative correlation between dysmorphic features and verbal IQ in children exposed to valproate. CONCLUSIONS: This study identifies valproate as a drug carrying potential risks for developmental delay and cognitive impairment and is the first to suggest that frequent tonic-clonic seizures have a similar effect. Our results need to be interpreted with caution given their retrospective nature. Women with epilepsy need careful counselling about individual risk benefit of AED treatment before pregnancy.
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Cites
Wechsler Intelligence Scale for Children
(2018) · The SAGE Encyclopedia of Intellectual and Developmental Disorders · doi:10.4135/9781483392271.n537 · Cited by 4,109
The Scottish Intercollegiate Guidelines Network (SIGN)
Miller, J. (2002) · The British Journal of Diabetes & Vascular Disease · doi:10.1177/14746514020020010401 · Cited by 1,544
The Teratogenicity of Anticonvulsant Drugs
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Epilepsy: Frequency Causes and Consequences
Hauser, W. A., & Hesdorffer, D. C. (1990) · Medical Entomology and Zoology · Cited by 587
A clinical study of 57 children with fetal anticonvulsant syndromes
Moore, S. J., Turnpenny, P., Quinn, A., Glover, S., Lloyd, D. J., Montgomery, T., & Dean, J. C. S. (2000) · Journal of Medical Genetics · doi:10.1136/jmg.37.7.489 · Cited by 562
Epilepsy: Frequency, causes and consequences
Messenheimer, J. A. (1991) · Journal of Epilepsy · doi:10.1016/0896-6974(91)90095-z · Cited by 562
Pattern of Malformations in the Children of Women Treated with Carbamazepine during Pregnancy
Jones, K. L., Lacro, R. V., Johnson, K. A., & Adams, J. (1989) · New England Journal of Medicine · doi:10.1056/nejm198906223202505 · Cited by 447
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MATERNAL EPILEPSY AND ABNORMALITIES OF THE FETUS AND NEWBORN
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Cited by
Meador, K. J., Baker, G. A., Browning, N., Cohen, M. J., Bromley, R. L., Clayton-Smith, J., Kalayjian, L. A., Kanner, A., Liporace, J. D., Pennell, P. B., et al. (2013) · The Lancet Neurology · doi:10.1016/s1474-4422(12)70323-x · Cited by 834
Cognitive Function at 3 Years of Age after Fetal Exposure to Antiepileptic Drugs
Meador, K. J., Baker, G. A., Browning, N., Clayton-Smith, J., Combs-Cantrell, D. T., Cohen, M., Kalayjian, L. A., Kanner, A., Liporace, J. D., Pennell, P. B., et al. (2009) · New England Journal of Medicine · doi:10.1056/nejmoa0803531 · Cited by 812
Valproic acid in pregnancy: how much are we endangering the embryo and fetus?
Ornoy, A. (2009) · Reproductive Toxicology · doi:10.1016/j.reprotox.2009.02.014 · Cited by 526
The prevalence of neurodevelopmental disorders in children prenatally exposed to antiepileptic drugs
Bromley, R. L., Mawer, G. E., Briggs, M., Cheyne, C., Clayton-Smith, J., Garcia-Finana, M., Kneen, R., Lucas, S. B., Shallcross, R., Baker, G. A., et al. (2013) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp-2012-304270 · Cited by 367
Treatment for epilepsy in pregnancy: neurodevelopmental outcomes in the child
Bromley, R., Weston, J., Adab, N., Greenhalgh, J., Sanniti, A., McKay, A. J., Tudur Smith, C., & Marson, A. G. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010236.pub2 · Cited by 277
Self-citation
Metadata
- Authors
- Adab, N.
- Venue
- Journal of Neurology, Neurosurgery & Psychiatry
- Publisher
- BMJ
- Published
- 2004-11-01
- Volume
- 75
- Issue
- 11
- Pages
- 1575-1583
- ISSN
- 0022-3050 (ISSN-L)
- OpenAlex
- W2113723870
- Cited by
- 580
- References
- 44
- FWCI
- 25.60
- Type
- journal article
- Language
- en
- Open access
- bronze
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