Effects of Maternal Use of Antiseizure Medications on Child Development

Neurol Clin. 2022 Nov;40(4):755-768. doi: 10.1016/j.ncl.2022.03.006. Epub 2022 Sep 28.

Abstract

Most children born to women with epilepsy (WWE) are normal, but have increased risks for malformations and poor neuropsychological outcomes. Antiseizure medications (ASMs) are among the most commonly prescribed teratogenic medications in women of childbearing age. However, WWE typically cannot avoid using ASMs during pregnancy. Teratogenic risks vary across ASMs. Valproate poses a special risk for anatomic and behavioral teratogenic risks compared with other ASMs. The risks for many ASMs remain uncertain. Women of childbearing potential taking ASMs should be taking folic acid. Breastfeeding while taking ASMs seems safe. WWE should receive informed consent outlining risks before conception.

Keywords: Anticonvulsants; Epilepsy; Malformations; Neurodevelopmental outcomes; Pregnancy.

Publication types

  • Review

MeSH terms

  • Anticonvulsants / adverse effects
  • Child
  • Child Development
  • Epilepsy* / drug therapy
  • Female
  • Folic Acid / therapeutic use
  • Humans
  • Pregnancy
  • Pregnancy Complications* / drug therapy
  • Valproic Acid / adverse effects

Substances

  • Valproic Acid
  • Anticonvulsants
  • Folic Acid