Association of Prenatal Exposure to Antiseizure Medications With Creative and Executive Function at Age 4.5 Years.
Publication/Presentation Date
6-25-2024
Abstract
BACKGROUND AND OBJECTIVES: Neurodevelopmental effects of fetal antiseizure medication (ASM) exposure on creativity and executive functions are poorly understood. We previously found fetal valproate exposure to adversely affect measures of creativity and executive functions. In this study, we examine fetal exposure of newer ASMs on these functions in children of women with epilepsy (WWE) compared with children of healthy women (HW).
METHODS: The Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs study is a multicenter NIH-funded prospective observational cohort study of WWE and HW enrolled in pregnancy and their offsprings. This report examines blindly assessed creativity and executive functions in 4.5-year-old children of WWE vs HW. In addition, exposure-dependent ASM effects during the third trimester were examined in children of WWE, using a ratio of maximum observed ASM concentrations and ratio of defined daily dose (ratio DDD). For polytherapy, ratios were summed across ASMs. Linear regression models adjusted for multiple potential confounding factors were conducted for all analyses. The primary outcome for 4.5-year-old children was the Torrance Test of Creative Thinking-Figural Creativity Index. Secondary outcomes included the Global Executive Composite Score from the Behavior Rating Inventory of Executive Function-Preschool Version and subscales and other indexes of both measures.
RESULTS: The primary analysis included 251 children of WWE and 73 of HW. No differences in creativity or executive function were found between children of WWE vs HW. No ASM exposure-dependent effects were found for the creativity measures, but exposure-dependent effects for executive function were present for ratio ASM concentration and ratio DDD.
DISCUSSION: Our findings at 4.5 years show no differences in creative thinking between children of WWE vs HW (-3.2 [-9.0 to 2.7],
TRIAL REGISTRATION INFORMATION: The study is registered at ClinicalTrials.gov as NCT01730170.
Volume
102
Issue
12
First Page
209448
Last Page
209448
ISSN
1526-632X
Published In/Presented At
Meador, K. J., Cohen, M. J., Loring, D. W., Matthews, A. G., Brown, C. A., Robalino, C., Carmack, A., Sumners, S., Birnbaum, A. K., Kalayjian, L. A., Gedzelman, E., Voinescu, P. E., Gerard, E. E., Hanna, J., Cavitt, J., Sam, M., Hwang, S. T., Pack, A. M., Tsai, J. J., Pennell, P. B., … Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs Investigator Group (2024). Association of Prenatal Exposure to Antiseizure Medications With Creative and Executive Function at Age 4.5 Years. Neurology, 102(12), e209448. https://doi.org/10.1212/WNL.0000000000209448
Disciplines
Medicine and Health Sciences | Pediatrics
PubMedID
38810172
Department(s)
Department of Pediatrics
Document Type
Article