Adaptive Behavior at Age 4.5 Years-old in Children of Mothers with Epilepsy vs. Healthy Mothers in the MONEAD Study
Abstract number :
2.319
Submission category :
11. Behavior/Neuropsychology/Language / 11B. Pediatrics
Year :
2022
Submission ID :
2204517
Source :
www.aesnet.org
Presentation date :
12/4/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:25 AM
Authors :
David Loring, PhD – Emory University Brain Health Center; Morris Cohen, Ed.D. – Pediatric Neuropsychology International; Page Pennell, M.D. – University of Pittsburgh; Abigail Matthews, Ph.D. – The Emmes Company; Carrie Brown, M.S. – The Emmes Company; Chelsea Robalino, MStat – The Emmes Company; Laura Kalayjian, M.D. – University of Southern California; Elizabeth Gerard, M.D. – Northwestern University; Evan Gedzelman, M.D. – Emory University; Julie Hanna, M.D. – Minnesota Epilepsy Group; Jennifer Cavitt, M.D. – University of Cincinnati; Maria Sam, M.D. – Wake Forest University; Sean Hwang, M.D. – Northwell Health; Alison Pack, M.D. – Columbia University; Jeffrey Tsai, M.D. – University of Washington; Kimford Meador, M.D. – Stanford University
Rationale: Adverse neurodevelopmental effects can occur from fetal exposure to antiseizure medications (ASMs). In addition to impairments in cognitive functioning, fetal ASM may affect behavior as reflected in abilities related to adaptive functioning. Here, we examine adaptive behavior ratings at age 4.5 years old in children of women with epilepsy (WWE) vs. healthy women (HW) in our ongoing Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD) study.
Methods: The MONEAD study is a prospective, observational, multi-center investigation of pregnancy outcomes. WWE and HW were enrolled during pregnancy. Children were assessed at age 4.5 years old using the Adaptive Behavior Assessment System, Third Edition (ABAS-3) which is a nationally standardized rating scale of adaptive functioning completed by each child’s mother. The General Adaptive Composite Standard Score was compared between children of WWE on medications to children of HW via a linear regression model adjusted for the same covariates as our prior 3 yo analyses of verbal abilities, which were mother's IQ, education level, age at enrollment, weeks gestation age at enrollment, post-birth average anxiety score, and child's ethnicity and sex.
Results: There were 250 children of WWE and 73 children of HW who were rated by their mothers using the ABAS-3 at age 4.5 years. The adjusted differences between General Adaptive Composite scores did not significantly differ between children of WWE (adjusted least squares mean, 95% CI = 101.4 (95% CI 100.0, 102.9)) vs. children of HW (adjusted least squares mean, 95% CIs = 99.4 (95% CI, 96.6, 102.2); p=0.223). See Figure 1 for scatter plot of scores and Table 1 for full model summary. Note that the WWE cohort were primarily on monotherapy (73%) with 82% of monotherapies were lamotrigine or levetiracetam, and 42% of polytherapies were on dual therapy with same two ASMs.
Conclusions: Our findings at 4.5 years old in MONEAD show no significant differences in overall adaptive functioning in children of WWE vs those of HW. These findings are consistent with a lack of differences in other cognitive abilities at age 3 years old. The MONEAD study will assess cognitive and behavioral outcomes at age 6 years old in the future. Additional studies are needed to understand neurodevelopmental effects of fetal exposure for most ASMs.
Funding: NIH, NINDS and NICHD, #U01-NS038455
Behavior