Maternal epilepsy and prenatal antiepileptic drug exposure: Relationships with neurodevelopmental outcomes in preschool-aged children

Appl Neuropsychol Child. 2026 May 30:1-9. doi: 10.1080/21622965.2026.2676804. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to investigate the associations of maternal epilepsy and prenatal antiepileptic drug (AED) exposure with neurodevelopmental outcomes in preschool-aged children, with a particular focus on adaptive functioning, emotional and behavioral problems, and autism spectrum disorder (ASD).

METHODS: This retrospective, case-control study included 53 children aged 2-6 years born to mothers with epilepsy and 53 age- and sex-matched controls whose mothers had no history of epilepsy or other chronic illness. Developmental outcomes and emotional problems were assessed using the Vineland Adaptive Behavior Scales-II (VABS-II), the Strengths and Difficulties Questionnaire (SDQ), and the Autism Behavior Checklist.

RESULTS: Linear regression analysis showed that prenatal AED exposure was significantly associated with lower total VABS-II scores (R² = 0.201, p = .040). Within the AED-exposed subgroup, higher standardized AED doses were negatively correlated with total VABS-II scores (r = -.425, p = .021). Hyperactivity/inattention and peer relationship problems were significantly higher in both AED-exposed and non-exposed epilepsy groups compared with controls (p < .05). Three cases of ASD were identified, all in the AED-exposed group.

CONCLUSIONS: Maternal epilepsy and prenatal AED exposure may be associated with differences in adaptive functioning and behavioral outcomes in preschool-aged children. These findings should be interpreted cautiously given the observational design and potential residual confounding.

PMID:42218586 | DOI:10.1080/21622965.2026.2676804