Effects of Maternal Epilepsy on Children's Neurodevelopment

To assess the neurodevelopmental consequences of epilepsy during pregnancy, we compared offspring of mothers with epilepsy and closely matched controls. Children of mothers with epilepsy were exposed to phenytoin (n = 29) or carbamazepine (n = 29) monotherapies. All children received age-appropriate measures of psychometric intelligence, motor skills, cognitive abilities, language, and temperament. Results indicated that epilepsy during pregnancy is associated with lower psychometric intelligence and less adequate language skills. Children exposed in utero to phenytoin were affected at a younger age and particularly in their language development, whereas children exposed to carbamazepine only showed effects past age 3. Regression analyses indicated an effect only on language skills due to maternal IQ and type of epilepsy. Although results are limited by small sample sizes, present findings suggest effects due to anticonvulsants regardless of seizure activity and more favorable outcome in children treated with carbamazepine than phenytoin.