The effect of anti-epileptic drugs on the behaviour of the fetus

The rich behavioural repertoire of the fetus provides a means of assessing central nervous system integrity, and thus the well-being of the fetus. Pregnancy in women with epilepsy is associated with a higher risk of congenital malformation and long-term developmental delay. The cause of these risks is thought to be the anti-epileptic drugs that women with epilepsy continue to take during pregnancy to prevent seizures. This thesis, using fetal behaviour as a diagnostic tool, studied the effect of the anti-epileptic drugs; Carbamazepine, Lamotrigine and Valproate on the fetal behaviour. The spontaneous behaviour and the habituation response of the fetus were examined at 12- 15, 18-22, 31 and 37 weeks of gestation in two groups of mothers; those mothers with epilepsy taking anti-epileptic drugs and a control group of mothers not having epilepsy and thus not taking anti-epileptic drugs. Further analyses examined the effects of the specific drug; mothers were taking Carbamazepine, Lamotrigine or Valproate with a group of mothers not taking anti-epileptic drugs. There was a significant difference between the fetuses in the Carbamazepine group and the control group higher at 12-15 weeks gestation. Total activity was significantly higher in the Carbamazepine group compared with fetuses not exposed to anti-epileptic drugs. Mean mouth movement scores were significantly lower at 18-22 weeks in fetuses exposed to Carbamazepine. Habituation performance was significantly different for the fetuses exposed to Carbamazepine at 31 weeks gestation. The . fetuses exposed to Carbamazepine showed a poorer habituation performance. Postnatally children who had been exposed Valproate scored significantly lower in both the mental and psychomotor developmental index scores of the Bayleys scale of Infant Development than children who had not been exposed to anti-epileptic drugs. Anti-epileptic drugs were observed to affect the behaviour of the fetus, suggestive of an effect on the central nervous system.EThOS - Electronic Theses Online ServiceGBUnited Kingdo