May-02-2009
Findings of a new study show that infants whose mothers were administered the epilepsy treatment with valproate during pregnancy possessed lower IQs when compared to the children whose mothers used other anti-spasm medications to cure epilepsy, a brain disorder that causes people to have recurring seizures.
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According to the lead author of the research, Dr. Kimford Meador of the Emory University, the study showed that children whose mothers took valproate to treat epilepsy possessed IQ tally that was six to nine points lower by the time they were three years old. In the United Stated, valproate is sold under the brand name depakote, and earlier had been associated with birth defects, especially spina bifida (a defect in the congenital neural tube than often results to neurological impairment). Hence, women who have achieved the child-bearing age have been advised not to take the drug.
Substantiating Dr. Kimford Meador's views on the subject, the director of the North American Antiepileptic Disease Pregnancy Registry situated at the Massachusetts general Hospital in Boston, Dr. Lewis Holmes affirmed that since long people have known valproate to be an awful performer. Dr. Holmes further said that the new research is significant as it is the largest study of its kind that demonstrates a link between valproate and reduced IQ. He said that the publication of the findings of the new study in the esteemed New England Journal of Medicine should serve as an awakening as well as warning for all physicians who have been so far paying no attention to the potential dangers of the drug on fetuses. Dr. Holmes was, however, not associated with the new research on the consequences of valproate on pregnant women.
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It has been found that on an average, approximately 25,000 children are born to women suffering from epilepsy (a disorder of the nervous system distinguished by mild episodic loss of attention or by acute seizures accompanied by unconsciousness) in the United States alone every year. The five-year-long new study was conducted on pregnant women in the United States and the United Kingdom between 1999 and 2004. And the findings of the research are established on around 260 children given birth by these women.
During the course of their research, scientists discovered that infants whose mothers had taken valproate during pregnancy possessed an IQ score of 92. On the other hand, children whose mothers had taken other medicines such as phenytoin, lamotrigine and carbamazepine to treat epilepsy during their gestation period had a higher IQ score ranging between 98 and 101. Normally, IQ tests are developed in such a way that a child having an average intelligence would be able to score 100.
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The scientists further discovered that the dosage of valproate taken by a woman during pregnancy is inversely proportional to the effect of the child's IQ. For instance, if a woman took a higher dosage of valproate, the lesser will be her child's IQ. However, this theory is not applicable or did not make any variation when pregnant women took other drugs to cure epilepsy.
Many experts are of the opinion that as very less number of children was included in the research, it is likely that other aspects may also have had an impact on the findings of the study. Nevertheless, the researchers took into account and explained various factors, including the dissimilarity in a child's weight at birth, their mother's age and IQ as well as the kind of epilepsy the mothers suffered from, that might have affected the results of the research. Dr. Lewis Holmes hints towards a key shortcoming of the study conducted by Dr. Kimford Meador and his team. He rightfully points out that researchers failed to include children whose mothers suffered from epilepsy but did not take any medication for this disease during their pregnancy.
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Dr. Lewis Holmes, who is also a professor of pediatrics at the Harvard Medical School, did not rule out the likelihood of all four epilepsy medications have some or other effect on the mental development of the children. According to Dr. Holmes, in the absence of a contrast group of children whose mothers did not take any of the medications for treating epilepsy during pregnancy, it is difficult to ascertain how much affect the use of valproate by pregnant women had on their child's mental development.
The study author Dr. Kimford Meador said that in addition to prescribing valproate to treat epilepsy, the drug is also used for curing migraine headaches and different mental frame syndromes. In fact, valproate is still being given to epilepsy patients because this drug functions best in such conditions, he said. On the other hand, many physicians recommend that women suffering from epilepsy should continue taking medications even during their pregnancy as convulsions may often cause them injuries.
In an editorial accompanying the new study, Swedish researcher Dr. Torbjorn Tomson wrote that epileptic women who are taking drugs and desire to be pregnant should plan their pregnancies cautiously. He advised all such women to consult their physicians before taking any step towards pregnancy. This is not only essential for the health of the mother, but also for the wellbeing of the fetus.
It is important to mention here that even if an epileptic woman switches from valproate to other medication after becoming aware of her pregnancy, it may not help to diminish the risk associated their child's mental development. At the same time, Dr. Torbjorn Tomson says that if a woman stops taking medicines suddenly after becoming pregnant, it may prove to be detrimental both for the mother and the fetus. Even study author Dr. Kimford Meador has agreed with Dr. Tomson on this issue saying, "Such an action could actually prove to be disastrous".
