neurodevelopmental disorders and delay (using antiepileptics in pregnancy)

Last edited 01/2021 and last reviewed 01/2021

Neurodevelopmental disorders and delay

A review also considered meta-analyses and epidemiological studies that investigated the risk of adverse effects on neurodevelopmental outcomes including measures of intelligence, developmental outcomes, and symptoms or diagnoses of autism spectrum disorders in children exposed in-utero to antiepileptic drugs.

These data support the following conclusions (1):

• for carbamazepine, lamotrigine, and levetiracetam, data do not suggest an increased risk of neurodevelopmental disorders or delay, however, due to the limitations of these data the possibility of an increased risk cannot be definitively ruled out

• for phenobarbital and phenytoin, although the clinical studies report inconsistent findings, the totality of the data show the possibility of adverse effects on neurodevelopment

• some recent data raise concerns that topiramate use during pregnancy may be associated with poorer developmental outcomes, however, the numbers in the available studies remain limited and further data are needed to reach firm conclusions

• for gabapentin, oxcarbazepine, pregabalin, and zonisamide the data are either lacking, extremely limited, or have limitations, and the risks remain uncertain

Reference:

• MHRA(January 2021).Antiepileptic drugs in pregnancy: updated advice following comprehensive safety review Drug Safety Update volume 14, issue 6: January 2021: 1