Research article summary (published 7 Mar 1994):

Neurodevelopment of children exposed in utero to phenytoin and carbamazepine monotherapy.

Full Abstract

OBJECTIVE--To compare pregnancy outcome prospectively after phenytoin and carbamazepine monotherapy with outcome in matched mother-child pairs exposed to nonteratogens to evaluate the relative fetal safety of these drugs. DESIGN--A prospective, controlled, and blinded observational study. PATIENTS--Thirty-six mother-child pairs exposed to carbamazepine monotherapy and 34 pairs exposed to phenytoin monotherapy, all prospectively studied, were compared with mother-child pairs exposed to nonteratogens. The controls were matched for maternal age, time of consultation, obstetric history, and socioeconomic status. MAIN OUTCOME MEASURE--The primary end point of interest was the children's global IQ measured by either the Bayley or the McCarthy scale according to their ages. SETTING--A teratology consultation program and two neurology services in Toronto, Ontario. RESULTS--Children exposed to phenytoin in utero had a mean (+/- SD) global IQ 10 points lower (95% confidence interval, 4.9 to 15.8 points) than their matched controls (113.4 +/- 13.1 and 103.1 +/- 25.1; P = .038). The Reynell language development scores followed a similar trend, with children exposed to phenytoin scoring significantly lower than their controls. Phenytoin-exposed children had a global IQ of 84 or less significantly more often than the control group (P < .01). Children exposed in utero to carbamazepine did not differ from their controls on any of the neurobehavioral tests. CONCLUSIONS--Our study suggests a clinically important negative effect of phenytoin on neurobehavioral development, independent of maternal or environmental factors, causing a substantial number of children to achieve a lower score than expected on cognitive tests. No similar effects could be shown after gestational use of carbamazepine.

Author information

Author/s: Scolnik, D (D); Nulman, I (I); Rovet, J (J); Gladstone, D (D); Czuchta, D (D); Gardner, H A (HA); Gladstone, R (R); Ashby, P (P); Weksberg, R (R); Einarson, T (T);

Affiliation: Motherisk Program, Hospital for Sick Children, Toronto, Ontario, Canada.

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't

Journal: JAMA : the journal of the American Medical Association (JAMA), published in UNITED STATES. (Language: eng)

Reference: 1994-Mar; vol 271 (issue 10) : pp 767-70

Dates: Created 1994/03/30; Completed 1994/03/30; Revised 2006/11/15;

PMID: 7509419, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: JAMA. 1994 Sep 21;272(11):850-1. (PMID: 7521402)

CommentIn: JAMA. 1994 Sep 21;272(11):850; author reply 851. (PMID: 7521401)

ErratumIn: JAMA 1994 Jun 8;271(22):1745.

External Links for this article
(including full text providers, if available):

Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.

This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.

MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Carbamazepine - adverse effects; therapeutic use Case-Control Studies Child Cognition - drug effects Developmental Disabilities - chemically induced Female Humans Intelligence Tests

Intelligence Tests Male Phenytoin - adverse effects; therapeutic use Pregnancy Pregnancy Complications - drug therapy Pregnancy Outcome Prenatal Exposure Delayed Effects Prospective Studies

Associated Chemicals: Carbamazepine (298-46-4) ; Phenytoin (57-41-0)

Related articles

These are the highest related articles currently in the database:

• Prenatal and family risks of children born to mothers with epilepsy: effects on cognitive development. 17 Dec 2007
• Volumetric MRI study of brain in children with intrauterine exposure to cocaine, alcohol, tobacco, and marijuana. 30 Mar 2008
• The psychological development of children of epileptic parents. II. The differential impact of intrauterine exposure to anticonvulsant drugs and further influential factors. 30 Aug 1994
• Long-term neuropsychological consequences of maternal epilepsy and anticonvulsant treatment during pregnancy for school-age children and adolescents. 30 Aug 1999
• Coumarins during pregnancy: long-term effects on growth and development of school-age children. 30 Mar 2001
• Development after prenatal exposure to cocaine, heroin and methadone. 30 Oct 1994
• Assessing epidemiological evidence for the teratogenic effects of anticonvulsant medications. 30 Mar 2002
• A repeated measures approach for simultaneous modeling of multiple neurobehavioral outcomes in newborns exposed to cocaine in utero. 29 Apr 2004
• Dysmorphic features: an important clue to the diagnosis and severity of fetal anticonvulsant syndromes. 18 Oct 2005

See 100+ related articles.

Related Article Map

Legend: - FREE Full text Article. - Abstract only. - Title only. More help.

See a large map of 100+ related articles.