Long-term neurocognitive adverse effects of prenatal antiepileptic drug exposure

Most women with epilepsy use antiepileptic medication during pregnancy because of seizure-related risks to mother and fetus. Most of the children exposed prenatally to antiepileptic medication are born healthy; however, there is increased risk for major congenital malformations and also unfavorable neurocognitive long-term development of the offspring. The increased risk has been correlated mainly with prenatal exposure to polytherapy and certain antiepileptic medications. Many confounding risk factors make it difficult to correlate the prenatal exposure and neurodevelopmental problems, and data of newer antiepileptic medications are lacking. In the future, larger prospective, controlled studies with extended follow-up are required to evaluate the long-term neurocognitive effects of prenatal antiepileptic medication exposure.