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- W2775763754 abstract "Prenatal exposure to sodium valproate andlevetiracetam: consequences for neurodevelopmental outcomes?Rebecca L. Bromley, PhD. For the award: Doctorate of ClinicalPsychology. Submitted to the University of Manchester June2012.Research has demonstrated that prenatal exposure toantiepileptic drugs is associated with an increased risk ofphysical malformations. The potential risk such exposure conveys tothe developing brain and therefore the later cognitive functioningof the child is now the focus of both national and internationalresearch. This thesis investigated the relationship betweenprenatal exposure to antiepileptic drugs and child cognitivefunctioning. This investigation was undertaken in three phases: asystematic review of the published literature; an original researchpiece investigating prenatal exposure to sodium valproate andlevetiracetam and finally a critical review of the researchundertaken as part of this thesis and in the wider publishedliterature.The systematic review identified 30 studies which hadinvestigated the cognitive abilities of children with a history ofprenatal exposure to antiepileptic drugs. Methodological quality ofthe studies was considered against the criteria of the NewcastleOttawa Scale. Differential findings were noted across theantiepileptic drug types, with the largest number of studiesdocumenting increased risks associated with prenatal exposure tosodium valproate. A lack of high quality research across allantiepileptic drugs, and in particular the more recently licensedantiepileptic drugs is highlighted. In the research paper presentedhere children aged between five and nine years of age exposed toeither levetiracetam (n=37), sodium valproate (n=40) or who wereborn to women with epilepsy but did not require medication (n=43)were recruited from throughout the UK. Demographic and healthinformation was collected from prospective records and supplementedwith maternal interview. Formal standardised neuropsychologicalassessments were undertaken to inform on the child’s current levelof intellectual, memory, language, attentional and executivefunctioning. Following adjustment for variables likely to influencechild cognitive ability, prenatal exposure to sodium valproate wasfound to be associated with poorer intellectual and languagefunctioning in a dose dependent manner. When stratified by dose,57.9% of children exposed to doses of sodium valproate above 800mgdaily scored below the average range for their global intellectualability. Prenatal exposure to levetiracetam was not found to beassociated with poorer cognitive functioning. The critical reviewhighlighted a number of methodological strengths of this research,despite time and resource implications. However, considerationshould be given to the retrospective nature of this cohort and thepotential for recruitment bias.This thesis concludes that women whorequire continuation of their treatment during pregnancy to controltheir seizures should be counselled regarding the risks and thebenefits…" @default.
- W2775763754 created "2017-12-22" @default.
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- W2775763754 date "2012-01-01" @default.
- W2775763754 modified "2023-09-24" @default.
- W2775763754 title "Prenatal exposure to sodium valproate and levetiracetam : consequences for neurodevelopmental outcomes?" @default.
- W2775763754 hasPublicationYear "2012" @default.
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