Child development following in utero exposure: Levetiracetam vs sodium valproate
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OBJECTIVE: Children born to women with epilepsy (WWE), exposed in utero to levetiracetam (LEV, n = 51), were assessed for early cognitive development and compared to children exposed to sodium valproate in utero (VPA, n = 44) and a group of children representative of the general population (n = 97). METHODS: Children were recruited prospectively from 2 cohorts in the United Kingdom and assessed using the Griffiths Mental Development Scale (1996), aged <24 months. Information regarding maternal demographics were collected and controlled for. This is an observational study with researchers not involved in the clinical management of the WWE. RESULTS: On overall developmental ability, children exposed to LEV obtained higher developmental scores when compared to children exposed to VPA (p < 0.001). When compared, children exposed to LEV did not differ from control children (p = 0.62) on overall development. Eight percent of children exposed to LEV in utero fell within the below average range (DQ score of <84), compared with 40% of children exposed to VPA. After controlling for maternal epilepsy and demographic factors using linear regression analysis, exposure to LEV in utero was not associated with outcome (p = 0.67). Conversely, when compared with VPA exposure, LEV exposure was associated with higher scores for the overall developmental quotient (p < 0.001). CONCLUSION: Children exposed to LEV in utero are not at an increased risk of delayed early cognitive development under the age of 24 months. LEV may therefore be a preferable drug choice, where appropriate, for WWE prior to and of childbearing age.
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Our results are supported by findings from a cohort study that children exposed to levetiracetam were not at increased risk for delayed development compared with unexposed children.
“Our results are supported by findings from a cohort study, which found that children exposed to levetiracetam were not at increased risk for delayed development compared with unexposed children (see online supplementary appendix C).42”
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- Authors
- Shallcross, R., Bromley, R. L., Irwin, B., Bonnett, L. J., Morrow, J., & Baker, G. A.
- Affiliations
- University of Liverpool (GB)
- Venue
- Neurology
- Published
- 2011-01-25
- Volume
- 76
- Issue
- 4
- Pages
- 383-389
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- PMC
- PMC3271390
- OpenAlex
- W2031334993
- Cited by
- 161
- References
- 26
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 8 · 2023: 8 · 2022: 12 · 2021: 9 · 2020: 4 · 2019: 6 · 2018: 5 · 2017: 5 · 2016: 12 · 2015: 14 · 2014: 17 · 2013: 21 · 2012: 24
- FWCI
- 20.14
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Neurology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion, other-oa)
- Bristol Research (University of Bristol) (submittedVersion)
- Explore Bristol Research (submittedVersion)
- Funders
- Pfizer
- GlaxoSmithKline
- Epilepsy Research UK
- Research Councils UK
- Eisai
- National Institutes of Health
- Medical Research Council
- National Institute of Neurological Disorders and Stroke (R01NS038455)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmacological Effects and Toxicity Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Epilepsy research and treatment
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Fetal and Pediatric Neurological Disorders
- Keywords
- maternal epilepsy, prenatal drug exposure, levetiracetam, valproic acid, child cognitive development, developmental quotient, antiepileptic drugs, pregnancy, Griffiths Mental Development Scales
- MeSH terms
- Levetiracetam, Anticonvulsants, Child Development, Child, Preschool, Cognition, Epilepsy, Female, Humans, Infant, Maternal-Fetal Exchange, Piracetam, Pregnancy, Pregnancy Complications, Prenatal Exposure Delayed Effects, Retrospective Studies, Valproic Acid, Maternal Exposure
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