Abstract Details

Title Verbal Abilities at Age 6-years-old of Children of Women with vs. Without Epilepsy in the MONEAD Study

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) S19 - Epilepsy Clinical Trials and Long-term Studies (4:42 PM-4:54 PM)

Poster/Presentation
Number 007

Background Antiseizure medications (ASMs) are all potential teratogens which might impair neurodevelopmental outcomes.

Objective To compare age 6-years-old neurodevelopmental outcomes of children of women with epilepsy (WWE) vs. healthy women (HW).

Design/Methods The Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD) study is a prospective, observational, multi-center investigation. WWE and HW were enrolled during pregnancy. The a priori primary neurodevelopmental outcome for children is age 6 Verbal Index score calculated by averaging Differential Ability Scales-II Word Definitions and Verbal Similarities subtests, Expressive One-Word Picture Vocabulary Test-4, Peabody Picture Vocabulary Test-4, and NeuroPSYchological Assessment-2 Phonological Processing, Comprehension of Instructions, and Sentence Repetition subtests. We compared the outcomes in children of WWE vs. HW using linear regression adjusting for potential confounders chosen via a stepwise selection algorithm. Missing age 6 outcomes were imputed from available age 3 data using multiple imputation.

Results Analyses included 298 children of WWE and 89 of HW. No difference on the primary outcome was present for children of WWE vs. HW (parameter estimate (95% CI)= -0.5 (-3.1,2.1), p=0.71)). Significant factors in the final model included mother's IQ (0.3 (0.2,0.4), p<.001), mother's education level (reference: college degree (advanced), no college degree (-5.9 (-9.4,-2.3), p=0.001), college degree (not advanced) (-3.0 (-5.6,-0.3) p=0.027)), mother's age at enrollment (0.3 (0.1,0.5), p=0.008), child's small for gestational age status: yes vs. no (-8.5 (-13.5,-3.5), p<.001), and child's sex: male vs. female (-2.9 (-5.0,-0.7), p=0.009). In children of WWE, 78% had mothers on lamotrigine or levetiracetam alone or in combination with another ASM(s) in 3rd-trimester.

Conclusions

Verbal abilities of children of WWE vs. HW did not differ at age 6-years-old. These findings are largely limited to lamotrigine and levetiracetam exposures in the children of WWE group. Additional research is needed to address the large number of ASMs with inadequate information on risks of fetal exposure.

Authors/Disclosures
Kimford J. Meador, MD, FAAN (Stanford University School of Medicine) PRESENTER	The institution of Dr. Meador has received research support from NIH. The institution of Dr. Meador has received research support from Eisai. The institution of Dr. Meador has received research support from Medtronics. The institution of Dr. Meador has received research support from The Epilepsy Consortium.
Morris Cohen (Pediatric Neuropsychology International)	No disclosure on file
David W. Loring, PhD, FAAN (Emory Univ, Dept of Neurology)	Dr. Loring has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. Dr. Loring has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for ILAE. The institution of Dr. Loring has received research support from NIH. Dr. Loring has received publishing royalties from a publication relating to health care.
Carrie Brown (Emmes)	No disclosure on file
Chelsea Robalino (Emmes)	No disclosure on file
Andrea Carmack (Emmes)	No disclosure on file
Abigail Matthews (The Emmes Company, LLC)	No disclosure on file
Page B. Pennell, MD, FAAN (University of Pittsburgh School of Medicine)	The institution of Dr. Pennell has received research support from NIH. The institution of an immediate family member of Dr. Pennell has received research support from Department of Defense. The institution of an immediate family member of Dr. Pennell has received research support from Environmental Protection Agency. The institution of an immediate family member of Dr. Pennell has received research support from NIH. The institution of an immediate family member of Dr. Pennell has received research support from Advanced Energy Consortium. Dr. Pennell has received publishing royalties from a publication relating to health care.