Abstracts

Children of epileptic mothers are described as having reduced cognitive abilities as compared to their peers. It is proposed that the deficit may be caused by exposure in utero to anti-epileptic drugs (AED) taken by the mother or anoxia due to maternal seizures during pregnancy. A better understanding of the relative effects of AED exposure and maternal seizures on cognitive functioning will be helpful in managing the pregnancies of epileptic women. Epileptic mothers taking AED were followed prospectively during their pregnancies. Drug doses, plasma levels and seizure occurrence were monitored frequently. When children reached school age (n=96) they underwent neuropsychological testing (NPT) to evaluate their cognitive and motor abilities. Mothers and fathers of these children also underwent NPT. A control group of 93 children of non-epileptic mothers, matched for age, education and socio-economic status, was also studied. Control children and their mothers and fathers also underwent NPT. The present data allow analyses that have not been possible in previous retrospective studies. We have found previously that children of epileptic mothers have lower Full Scale IQ (FIQ) than controls (exposed FIQ = 102.42, 95% sd = 15.45; control FIQ = 112.18, sd = 11.46, p [lt]0.001). There was no difference between FIQ of children of mothers who had seizures during the pregnancy than of those who did not (seizures = 100.33, sd 12.57; no seizures = 99.31, p = 0.858). There was no difference in FIQ between children whose mothers had primary generalized seizures (PGS) and partial seizures (PS) during pregnancy (PGS = 101.5, sd = 18.98; PS = 103.83, sd = 10.16, p= 0.56). Children exposed to AED polytherapy had lower FIQ compared to AED monotherapy, but the difference was not statistically significant (poly = 98.90, sd = 18.54, mono = 104.33, sd = 12.08, p= 0.198). Children exposed to either Dilantin or Tegretol in utero showed no difference in FIQ at school age (Dilantin = 106.60, sd = 14.16; Tegretol = 104.45, sd = 8.48, p = .677). The present analyses indicate that the reduced cognitive ability of children of epileptic mothers is due to exposure to AED in utero rather than to maternal seizures during pregnancy. Further analyses will be carried out on specific subtests of the NPT battery to determine whether cognitive differences between the exposed and control groups are limited to certain cognitive abilities. (Supported by Fonds de Recherche en Sante de Quebec.)