Epilepsy drug exposure in womb may affect school grades: study

Moms-to-be, take note! Taking epilepsy drugs during pregnancy may affect your child's grades in school, a study has found.

Researchers recommend that moms-to-be need to be fully informed of the risks of treatment, but these should be weighed against the need for effective seizure control during pregnancy.

"While this study highlights the risk of cognitive effects in the children of mothers prescribed sodium valproate or multiple (anti-epilepsy drugs), it is important to acknowledge that some epilepsies are difficult to manage without these treatment regimens," said Mark Rees from Swansea University in the UK.

Women with epilepsy who need drugs to control their seizures are currently advised to continue taking them during pregnancy because convulsions can harm both mother and the unborn child.

Several studies indicate that epilepsy drugs, particularly sodium valproate, taken during pregnancy, are associated with neurodevelopmental disorders, but few of these studies have been based on real-life population circumstances (population data).

For the study, published in the Journal of Neurology Neurosurgery & Psychiatry, the researchers used healthcare data from the Secure Anonymous Information Linkage (SAIL) databank and national school test (key stage 1) data to compare the academic performance of seven-year-olds born to mothers with epilepsy.

The Key Stage 1 (KS1) test assesses maths, language (English/Welsh) and science among seven-year-olds, scoring them from levels 1 to 3.

Test results were available for 440 children whose mothers had been diagnosed with epilepsy before their pregnancy for 2003 through to 2008.

The results showed that children born to mothers who had been prescribed carbamazepine or lamotrigine, or nothing, performed just as well as those born to mothers of the same age and deprivation level, but without epilepsy (comparison group).

However, those whose mothers had been prescribed sodium valproate during their pregnancy performed 10.5 - 13 per cent less well on all KS1 tests than those in the comparison group.

Children born to mothers who had been prescribed a combination of epilepsy drugs achieved worse results.