Language, intelligence, and educational outcomes of adolescents with antenatal exposure to antiseizure medications: Prospective data from the Kerala Registry of epilepsy and pregnancy

Thomas, Sanjeev V; Salim, Salma; Jacob, Nikita Susan; Jose, Manna; Salini, Reshma A; Selvaraj, Sajith; Gomez, Treasa Stemy; Sreedharan, Hema; Jeemon, Panniyammakal

doi:10.1016/j.seizure.2022.06.005

Cited by 2 publications

(2 citation statements)

References 30 publications

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“…Children with complex febrile seizures are prone to secondary epilepsy, which can seriously affect their growth and development ( 5 - 7 ). This study was designed to explore risk factors for secondary epilepsy in children with complex febrile seizures.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for secondary epilepsy in children with complex febrile seizures and their effect on growth and development—a retrospective cohort study

Duan¹,

Liao²,

Guo³

et al. 2023

Transl Pediatr

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Background Complex febrile seizures are prolonged and can cause neurologic abnormalities, leading to secondary epilepsy and affecting growth and development. At present, the mechanism of secondary epilepsy in children with complex febrile seizures is not clear, and this study aimed to explore the risk factors for secondary epilepsy in children with complex febrile seizures and analyze its effects on the growth and development of children. Methods The data of 168 children with complex febrile seizures admitted to the Ganzhou Women and Children’s Health Care Hospital between January 2018 and December 2019 were collected retrospectively and divided into a secondary epilepsy group (n=58) and control group (n=110) according to whether the children had secondary epilepsy or not. The differences in clinical features between the 2 groups were compared, and logistic regression analysis was used to explore the risk factors for secondary epilepsy in children with complex febrile seizures. A nomogram prediction model for secondary epilepsy in children with complex febrile seizures was established and verified using the R 4.0.3 statistical software, and the effect of secondary epilepsy on the growth and development of children was analyzed. Results Multivariate logistic regression analysis showed that family history of epilepsy, generalized seizures, number of seizures, and duration of seizures were independent influencing factors of secondary epilepsy in children with complex febrile seizures (P<0.05). The dataset was randomly divided into a training set and a validation set, with a sample size of 84 in the training set and 84 in the validation set. The area under the receiver operating characteristic (ROC) curve of the training set was 0.845 (95% confidence interval: 0.756–0.934), and the area under the ROC curve of the validation set was 0.813 (95% confidence interval: 0.711–0.914). Compared with the control group, the Gesell Development Scale score in the secondary epilepsy group was significantly reduced (77.84±8.86 vs. 85.64±8.65, P<0.001). Conclusions The nomogram prediction model could better identify complex febrile seizures children at high risk of secondary epilepsy. Strengthening intervention in such children may be beneficial for improving their growth and development.

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Section: Discussionmentioning

confidence: 99%

Risk factors for secondary epilepsy in children with complex febrile seizures and their effect on growth and development—a retrospective cohort study

Duan¹,

Liao²,

Guo³

et al. 2023

Transl Pediatr

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“…Some WWE face challenges in providing optimal care and support to their babies during the critical period of pregnancy and early infancy [10]. It is critical to identify children of WWE who are at risk of developmental problems in early infancy, as early detection of developmental delay provides opportunities to offer appropriate remedial therapies to the infants [11]. In this study, we aimed to assess the motor and mental developmental outcomes of infants of WWE according to antenatal exposure to ASM.…”

mentioning

confidence: 99%

Differential impact of antenatal exposure to antiseizure medications on motor and mental development in infants of women with epilepsy

Thomas

Jeemon

Jose

et al. 2022

Epileptic Disorders

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Objective. We aimed to determine a possible association between motor and mental development in infants of women with epilepsy and antenatal exposure to antiseizure medication (ASM). Methods. Developmental paediatricians who were blinded to antenatal ASM exposure evaluated motor and mental development of infants (>12 months) using the Developmental Assessment Scale for Indian Infants (an Indian adaptation of the Bayley Scale of Infant Development). Motor (MODQ) and mental development quotients (MEDQ) were computed as ratios of respective developmental age to the chronological age of the child. We employed linear mixed models to study the relationship between antenatal exposure to ASM and the development quotients after adjustment for malformation status and age of the baby, maternal education and seizure type. Results. We studied 1,357 infants with mean age of 15.3AE4.0 months (71.2% of all eligible infants). Infants were classified as having monotherapy or polytherapy, or unexposed in 840, 407 and 110 participants, respectively. The MEDQ of the polytherapy (92.9AE14.9) and monotherapy (96.9AE13.9) groups was lower than that of unexposed infants (99.8AE12.5). Similarly, the MODQ of polytherapy (91.1 AE19.3) and monotherapy (96.6AE17.5) groups was lower than that of unexposed infants (97.6AE16.6). The differences in adjusted mean MEDQ were -7.4 (-11.4 to -4.3, p=0.001), -9.6 (-11.3 to -6.0, p=0.001) and -6.4 (-9.2 to -3.7, p=0.001) for valproate monotherapy, polytherapy with valproate and polytherapy without valproate, respectively. The adjusted mean MODQ also showed a similar trend. Those exposed to levetiracetam (n=62) had higher or similar adjusted MODQ (110.4 AE14.3; p=0.001) and MEDQ (104.3AE9.1; p=0.09), compared to unexposed infants. A dose-dependent decrease in developmental indicators was observed for valproate and phenobarbitone. Significance. Antenatal exposure to ASM, especially valproate and phenobarbitone, adversely affects motor and mental development of exposed infants. Early developmental screening of high-risk infants is desirable.

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Language, intelligence, and educational outcomes of adolescents with antenatal exposure to antiseizure medications: Prospective data from the Kerala Registry of epilepsy and pregnancy

Cited by 2 publications

References 30 publications

Risk factors for secondary epilepsy in children with complex febrile seizures and their effect on growth and development—a retrospective cohort study

Risk factors for secondary epilepsy in children with complex febrile seizures and their effect on growth and development—a retrospective cohort study

Differential impact of antenatal exposure to antiseizure medications on motor and mental development in infants of women with epilepsy

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