Children exposed to epilepsy drugs in the womb are at increased risk of having impaired fine motor skills, a new study suggests, but exposure to the drugs in breast milk, however, does not appear to pose a threat.
Researchers looked at data collected from Norwegian mothers about their children's language, behaviour, and motor and social skills at the ages of 6 months, 18 months and 36 months. The women also provided information on breast-feeding during the first year of the study, which was published online in the journal JAMA Neurology.
A total of 223 children were exposed to one or more epilepsy drugs in the womb during the length of the study.
At the age of six months, 11.5% of infants whose mothers took epilepsy drugs during pregnancy had impaired fine motor skills (which involve small muscle movements) compared with less than 5% of those who were not exposed to epilepsy drugs.
Using more than one type of epilepsy drug during pregnancy was associated with impairments in both fine motor and social skills.
Exposure to epilepsy drugs in breast milk was not associated with any harmful effects for the age groups included.
Safe to breastfeed
Although the study found that exposure to epilepsy drugs in the womb was associated with a risk for impaired motor skills in infants, it did not prove a cause-and-effect relationship.
"Women with epilepsy should be encouraged to breastfeed their children irrespective of anti-epileptic medication use," said Dr Gyri Veiby, of the University of Bergen in Norway.
Veiby has received travel support from drugmaker UCB Pharma and lecture fees from GlaxoSmithKline, the study disclosed.
The findings provide additional evidence that it is safe to breastfeed while taking epilepsy drugs, wrote Dr Paul van Ness, of the University of Texas Southwestern Medical Centre in Dallas.
"Pregnant women with epilepsy often ask whether they will be able to breastfeed," he said.
"Many have been given conflicting advice when there were scant data to answer the question."
The American Academy of Family Physicians has more about epilepsy and pregnancy.