Background and aims The long-term effects of intra-uterine exposure antiepileptic drugs (AEDs) on cognitive functioning are limited and conflicting. The aim of the study was to assess the remote effects of fetal AEDs on cognitive outcomes in children.
Methods Children, aged 2–4 years, with fetal exposure of carbamazepine (CBZ), lamotrigine (LTG) or valproate (VPA) monotherapy were recruited from the local registry of Epilepsy-Pregnancy. Neuropsychological assessment was performed in all cases with Learning Accomplishment Profile (LAP) for children of 1–6 years. All age groups were evaluated with Wide Range Assessment of Visual Motor Abilities (WRAVMA) tests. The results were compared to the results of the epidemiological study evaluating developmental achievements in general preschool children population.
Results In total 39 children were assessed. Eleven (28%) were exposed to intra-uterine VPA, 22 (56%) to CBZ and six (15%) to LTG. From whole group poor performance in expressive speech was detected in nine persons (23%; 95% CI 12% - 44%) and there were no cases with fetal exposure to LTG. Out of children with fetal-VPA exposure (n = 11) the speech problems were observed in three cases (27%); from 22 children with CBZ intra-uterine exposure – in six (27%); no significant deficits were revealed in other developmental milestones.
Conclusions The data of our study suggests that difficulties in verbal abilities are more often associated with fetal exposure to VPA and CBZ. For more conclusive results further profound neuropsychological evaluations are needed.