Two-Year-Old Cognitive Outcomes in Children of Pregnant Women With Epilepsy in the Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs Study
US cohort study found no differences in 2-year-old children of 456 women with epilepsy (most on lamotrigine &/or levetiracetam) vs. healthy women, on primary outcome of language domain scores of Bayley Scales of Infant and Toddler Development 3rd ed, or in 4 of the other domains.
Source:
JAMA Internal Medicine
SPS commentary:
According to an editorial, the researchers behind the landmark Neurodevelopmental Effects of Antiepileptic Drugs (NEAD) study from 2009 have enrolled a new cohort of pregnant women in the Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD) study, with the intention of assessing cognitive outcomes in their children at 6 years of age, as in the NEAD study, but the main difference is that this new cohort better reflects current treatment of epilepsy with preferentially second-generation antiepileptics. It notes the overall message of this interim analysis at 2 years of age is reassuring for infant development, and the final assessment of children at 6 years of age, when the complexity of cognitive development has increased, is eagerly awaited. It adds that although many initiatives to collect data on the physical risks associated with in utero exposure to antiepileptics have been undertaken, too few engage in longer-term investigation and broad-spectrum change is required to reposition neurodevelopmental outcomes centrally and acknowledge the importance of these data for the optimisation of care provided to women with epilepsy.