Projects per year
Abstract
Objective: Many women with epilepsy need to continue anti-seizure medications (ASMs) throughout pregnancy. The current study investigated adaptive behaviour outcomes in children exposed to topiramate in the womb. Method: An observational, cross-sectional study was designed, recruiting mother-child-pairs from the UK Epilepsy and Pregnancy Register (UKEPR). Health, developmental histories and Vineland Adaptive Behaviour Scale-Third Edition (VABS-III) assessments were administered via telephone by a blinded researcher, supplemented with prospectively collected pregnancy and medication information. Topiramate monotherapy exposed children were compared to VABS-III normative data as recruitment was disrupted by the COVID-19 pandemic. Results: Thirty-four women with epilepsy from 135 (25%) initially agreed to participate in the study, of whom 26 women completed telephone interviews about their children (n = 28). Children ranged from 2.5 to 17 years of age at the time of assessment. Six topiramate-exposed children were born small for gestational age, and there were significant associations between birthweight, dose and VABS-III scores. Significantly lower scores were observed in topiramate-exposed children (n = 21) with a significant dose-response relationship established after adjustment for parental educational level. Daily mean dosage was 280.21 mg, with high dosages of topiramate associated with a 12-point reduction in VABS-III scores. Additionally, four topiramate-exposed children (19.05%) had diagnoses of Autism Spectrum Disorder, which was significantly higher than UK prevalence rates (1.1%). Conclusions: The findings of poorer adaptive behaviour, higher incidence of ASD and associations with birth weight are of concern and require further validation and replication using larger prospectively-recruited samples and comparator cohorts. Implications for research and clinical practice are discussed.
Original language | English |
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Pages (from-to) | 56-64 |
Number of pages | 9 |
Journal | Seizure |
Volume | 105 |
Early online date | 13 Jan 2023 |
DOIs | |
Publication status | Published - 1 Feb 2023 |
Keywords
- Antiseizure medications
- Autism
- Epilepsy
- Neurodevelopment
- Pregnancy
- Topiramate
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Dive into the research topics of 'Adaptive behaviour in children exposed to topiramate in the womb: an observational cohort study'. Together they form a unique fingerprint.Projects
- 1 Finished
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PRIME-RU: Perinatal Mental Health and Parenting Research Unit (PRIME-RU)
Wittkowski, A. (PI), Gregg, L. (CoI), Wan, M. (CoI), Smith, D. (CoI), Lemetyinen, H. (Researcher), Reid, H. (Researcher) & Millard, L. (Researcher)
1/10/20 → 31/03/24
Project: Research