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From University Department of Neurosciences (Drs. Vinten, Adab, Gorry, and Baker), Liverpool; Department of Genetics St. Mary's Hospital (Dr. Kini), Manchester; and Department of Child Health (Dr. Gregg), Alder Hey Hospital, UK.
Address correspondence and reprint requests to Prof. Gus A. Baker, Professor of Clinical Neuropsychology, University Department of Neurosciences, Walton Centre for Neurology and Neurosurgery, Lower Lane, Liverpool, L9 7LJ, UK; e-mail: g.baker{at}liv.ac.uk
Objective: To investigate the long-term differential drug effects on cognitive functioning in school-aged children exposed to antiepileptic drugs (AEDs) in utero.
Methods: Mothers with epilepsy were recruited from specialist epilepsy clinics and obstetric clinics from the Liverpool and Manchester region. The mothers and their children were recruited without prior knowledge of their AED treatment during pregnancy or the health of the offspring. A battery of neuropsychological tests was applied to each mother–child pair in order to obtain a neuropsychological profile for each child.
Results: Neuropsychological investigation was performed on 249 children between the ages of 6 and 16. Children exposed to sodium valproate had a significantly lower verbal IQ when compared to children exposed to other antiepileptic drugs or not exposed at all. The same children were more likely to have an IQ below 69 and more likely to have memory impairment when compared to the other groups. The mothers' IQ, exposure to sodium valproate, and the number of tonic-clonic seizures during pregnancy were significant predictors of verbal IQ in this population.
Conclusions: This retrospective study highlights the potential harmful effects of sodium valproate exposure in utero on neuropsychological development.
See also pages 938, 955, and 961
*Members of the Liverpool and Manchester Neurodevelopment Study Group are listed in the Appendix.
Received March 23, 2004. Accepted in final form September 8, 2004.
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