Abstracts

Rationale: Previously the Liverpool and Manchester Neurodevelopment group (LMNDG) reported that Levetiracetam (LVT) has little impact upon the developmental abilities of children, under the age of two years, exposed to this AED in utero. This is in contrast to some older anti epileptic drugs, such as Sodium Valproate (VPA), whereby impairment of development after in utero exposure has been reported. The LMNDG reports its preliminary findings of children exposed in utero to LVT compared with children exposed in utero to VPA at three to four years of age. Methods: Children exposed to either LVT monotherapy (n=40) or VPA monotherapy (n=32) were prospectively recruited from the UK Epilepsy and Pregnancy Register (UKEPR). Control children, born to women without epilepsy, not taking medication during pregnancy ( n=125) were prospectively recruited from the LMNDG programme of research. All children were assessed using the Griffiths Mental Development scales (2-8 years) and the Reynell Development Language Scales III. All mothers were assessed using the national adult reading test (NART) a standardised prediction of IQ. Further information on maternal demographic and epilepsy variables was collected. ANOVA was conducted to compare group means. Regression analysis was then performed in order to control for confounding variables. Results: Children exposed to LVT in utero did not differ significantly from control children on scores for the Griffiths Mental Development Scales or the Reynell Language Scales, with the exception of expressive language ability whereby significantly higher scores were seen in children exposed to LVT (p=0.04, m=52 vs m=46). Children exposed in utero to LVT obtained significantly higher scores than children exposed to VPA for their locomotor skills (p=0.001, m=112 vs m=93), personal and social skills (p=0.018, m=116 vs m=103), and their hand and eye coordination skills (p=0.019, m=106 vs m=95). Similarly, children exposed to VPA had lower scores than children exposed to LVT on their expressive language abilities (p=0.01, m=40.7 vs m=52). For comprehension of language abilities those exposed to VPA did not score significantly below those exposed to LVT (p=0.14, m=43 vs m=49), but they were significantly below control children (p=0.001, m=43 vs m=52). Conclusions: The preliminary results reported here suggest that exposure to LVT in utero does not have a negative effect upon the neurodevelopment and language abilities of children aged three to four years. VPA exposure, on the other hand is associated with a poorer level of ability in some cognitive domains. Data collection for this study is on-going.