-- Robert Preidt
WEDNESDAY, Jan. 23 (HealthDay News) -- Children of mothers who
take the antiepileptic drug valproate during pregnancy have lower
IQ scores at age 6, a new study says.
And the higher the dose of valproate during pregnancy, the
greater the effect on a child's IQ, according to the report
published in the Jan. 22 issue of
The Lancet Neurology.
For the study, the researchers looked at 305 pregnant women in
the United States and United Kingdom who took a single drug to
treat the seizure disorder -- either valproate (Depakote),
carbamazepine (Tegretol), lamotrigine (Lamictal) or phenytoin
At age 6, the IQ of children whose mothers took valproate during
pregnancy was seven to 10 points lower than children whose mothers
took another antiepileptic drug. Exposure to valproate was also
associated with poorer speaking and memory abilities.
"These results build on our earlier work to show that valproate usage during pregnancy has a significant negative effect on children's IQ, which lasts beyond their earliest years," said study leader Kimford Meador, a professor in the neurology department at Emory University in Atlanta.
"IQ at age 6 is strongly predictive of adult IQ and school performance, so our research suggests that valproate use during pregnancy is likely to have long-term negative effects on a child's IQ and other cognitive [mental] abilities," Meador added in a journal news release.
Another expert said the study is practice-changing.
"This important work has changed the way we practice neurology, leading us to conclude that valproate should not be used, if at all possible, in women of child-bearing potential," said Dr. Cynthia Harden, chief of the division of epilepsy and electroencephalography at the Cushing Neuroscience Institute in Manhasset, N.Y.
"The risks of valproate during pregnancy are clearly demonstrated, as the children in this research cohort continue to grow," said Harden.
However, the researchers also found that over time IQ may
improve for children exposed to valproate in the womb, and that
folic acid supplementation in mothers-to-be may improve children's
Harden called the finding about folic acid's mitigating effect
"reassuring and fascinating, since the mechanism of how
intrauterine valproate exposure causes cognitive [thinking] and
behavioral problems in children is unknown."
For some patients, valproate is the only drug that can control
their seizures. This may give particular importance to the findings
that higher drug doses have a greater impact on IQ and that folic
acid supplementation may have a positive effect on IQ, the
Meador said more research in this area is urgently needed, given
that many women with epilepsy do not have the option of stopping
medication during pregnancy.
After a 2009 study found that taking valproate during pregnancy
affected children's IQ at age 3, the U.S. Food and Drug
Administration issued a warning that valproate exposure in the womb
is associated with impaired mental function in children.
The Epilepsy Foundation has more about
pregnancy and epilepsy medications.
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