Maternal epilepsy and behavioral development of the child: Family factors do matter

Huber‐Mollema, Yfke; Oort, Frans J.; Lindhout, Dick; Rodenburg, Roos

doi:10.1016/j.yebeh.2019.03.030

Cited by 4 publications

(8 citation statements)

References 28 publications

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“…Higher scores indicate more problems. In a previous paper, we gave descriptive information on the level of parenting stress in mothers with epilepsy [10]. In this study, we used the total parenting stress score as possible predictor of the impact of maternal epilepsy on daily functioning and family life.…”

Section: Parenting Stressmentioning

confidence: 99%

“…They first showed a significant direct effect, but when all predictors were entered to the model, epilepsy severity and quality of life were found to be the more important contributors. Parenting stress and behavioral problems are indicative of maternal emotional well-being [32] and were found to be important predictors of child behavioral problems [10]. With respect to the impact of maternal epilepsy on daily functioning, epilepsy-related factors (such as seizure frequency) seem more important.…”

Section: Tablementioning

confidence: 99%

“…Women of childbearing age have further challenges around epilepsy, pregnancy, and motherhood [5][6][7][8][9]. We previously showed that mothers with epilepsy experienced more parenting stress compared with mothers from the general population [10].…”

Section: Introductionmentioning

confidence: 99%

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Well-being of mothers with epilepsy with school-aged children

Huber‐Mollema

Oort

Lindhout

et al. 2020

Epilepsy & Behavior

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The purpose of the study was to examine different aspects of well-being in mothers with epilepsy with school-aged children. Methods: In an observational study, mothers, identified from the European Registry of Antiepileptic Drugs and Pregnancy database in the Netherlands, completed questions on epilepsy, the impact of epilepsy on daily functioning, quality of life, behavioral problems, and parenting stress. Descriptive analyses were performed to examine the prevalence of behavioral problems and the impact of epilepsy on different aspects of the mother's daily functioning and family life. We subsequently investigated which factors contributed most to the impact of maternal epilepsy using regression analyses. Results: One hundred fifty-six (46%) of the 342 invited mothers with epilepsy participated. The majority (89%) had low epilepsy severity, with well-controlled seizures. Internalizing problems within the borderline or clinical range were reported by 23% of the mothers. Behavioral problems were significantly correlated with epilepsy severity (r = 0.26, p = .002), impact of epilepsy on daily functioning (r = 0.32, p b .001), and quality of life (r = −0.52, p b 01). Quality of life was in general good (mean = 8, standard deviation [SD] = 1), with low impact of epilepsy. Epilepsy affected mostly maternal self-confidence, work, and general health. Mothers indicated to experience no to little impact of epilepsy on the relationship with their children, partner, or family. Regression analyses showed that epilepsy severity (1.0, 95% confidence interval [CI]: 0.4 to 1.6; p = .002) and quality of life (−1.3, CI: −2.3 to −0.4; p = .007) were significant contributors to the impact of epilepsy on daily functioning, while other factors (maternal education, family type, behavioral problems, and parenting stress) were nonsignificant. Discussion: The current study shows that mothers with epilepsy generally fared well. Epilepsy negatively impacted the lives of some mothers, though. As maternal well-being is of importance for mother-child interaction and child development, clinicians should be aware of the impact of epilepsy on maternal psychosocial outcomes and family life of women with epilepsy.

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Section: Parenting Stressmentioning

confidence: 99%

Section: Tablementioning

confidence: 99%

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Well-being of mothers with epilepsy with school-aged children

Huber‐Mollema

Oort

Lindhout

et al. 2020

Epilepsy & Behavior

Self Cite

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show abstract

“…[10][11][12] On the other hand, pregnancy and delivery can be without complications. 5,6 Also, the teratogenic risk of antiepileptic drugs, 13,14 as their use during pregnancy increases the risk of fetal malformation and hemorrhage in the neonatal period, is known. 15,16 In Africa, some studies have been devoted to reproductive health in epileptic women, but very few have focused on the prognosis and pregnancy outcome among these women.…”

Section: Introductionmentioning

confidence: 99%

“… 10 11 12 On the other hand, pregnancy and delivery can be without complications. 5 6 Also, the teratogenic risk of antiepileptic drugs, 13 14 as their use during pregnancy increases the risk of fetal malformation and hemorrhage in the neonatal period, is known. 15 16 …”

Section: Introductionmentioning

confidence: 99%

Prognosis of Pregnancy in Epileptics in Benin: A Case–Control Study

Adoukonou

Agbétou

Sidi

et al. 2020

JNRP

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Objective The main purpose of this article is to define prognosis of pregnancies in epileptic women in Benin. Methods This was a case–control study that included 54 epileptic women who had at least one pregnancy matched to 162 controls on age, pregnancy term, and monitoring center. Information about epilepsy, treatment, pregnancy, and childbirth were collected. A logistic regression with odds ratio (OR) calculation was used to study the association. Results During pregnancy 22.22% of epileptic women experienced an increase in seizure frequency. Epileptics had more frequent miscarriages (OR: 1.84 [1.01–3.51]), more incidents during pregnancy (OR: 4.03 [1.04–15.60]), and were more often hospitalized (OR: 3.35 [1.46–7.69]) than women without epilepsy. They, more often, had premature children before 37 weeks of amenorrhea (OR: 2.10 [1.12–3.91]) and gave birth to low-birth-weight children (OR = 2.17 [1.00–4.76]). Conclusion Occurrence of a pregnancy in an epileptic woman in Benin is at risk and requires multidisciplinary monitoring by both neurologist and obstetrician to reduce complications.

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Behavioral Outcomes and Neurodevelopmental Disorders Among Children of Women With Epilepsy

Cohen,

Meador,

Loring

et al. 2024

JAMA Neurol

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ImportanceThe association of fetal exposure to antiseizure medications (ASMs) with outcomes in childhood are not well delineated.ObjectiveTo examine the association of fetal ASM exposure with subsequent adaptive, behavioral or emotional, and neurodevelopmental disorder outcomes at 2, 3, and 4.5 years of age.Design, Setting, and ParticipantsThe Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD) study is a prospective, observational cohort study conducted at 20 epilepsy centers in the US. A total of 456 pregnant women with epilepsy or without epilepsy were enrolled from December 19, 2012, to January 13, 2016. Children of enrolled women were followed up with formal assessments at 2, 3, 4.5, and 6 years of age. Statistical analysis took place from August 2022 to May 2023.ExposuresExposures included mother’s epilepsy status as well as mother’s ASM blood concentration in the third trimester (for children of women with epilepsy). Women with epilepsy were enrolled regardless of ASM regimen.Main Outcomes and MeasuresThe primary outcome was the Adaptive Behavior Assessment System, Third Edition (ABAS-3) General Adaptive Composite (GAC) score among children at 4.5 years of age. Children of women with epilepsy and children of women without epilepsy were compared, and the associations of ASM exposures with outcomes among exposed children were assessed. Secondary outcomes involved similar analyses of other related measures.ResultsPrimary analysis included 302 children of women with epilepsy (143 boys [47.4%]) and 84 children of women without epilepsy (45 boys [53.6%]). Overall adaptive functioning (ABAS-3 GAC score at 4.5 years) did not significantly differ between children of women with epilepsy and children of women without epilepsy (parameter estimate [PE], 0.4 [95% CI, −2.5 to 3.4]; P = .77). However, in adjusted analyses, a significant decrease in functioning was seen with increasing third-trimester maximum ASM blood concentrations (PE, −7.8 [95% CI, −12.6 to −3.1]; P = .001). This decrease in functioning was evident for levetiracetam (PE, −18.9 [95% CI, −26.8 to −10.9]; P &lt; .001) and lamotrigine (PE, −12.0 [95% CI, −23.7 to −0.3]; P = .04), the ASMs with sample sizes large enough for analysis. Results were similar with third-trimester maximum daily dose.Conclusions and RelevanceThis study suggests that adaptive functioning of children of women with epilepsy taking commonly used ASMs did not significantly differ from that of children of women without epilepsy, but there was an exposure-dependent association of ASMs with functioning. Thus, psychiatric or psychological screening and referral of women with epilepsy and their offspring are recommended when appropriate. Additional research is needed to confirm these findings.

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Maternal epilepsy and behavioral development of the child: Family factors do matter

Cited by 4 publications

References 28 publications

Well-being of mothers with epilepsy with school-aged children

Well-being of mothers with epilepsy with school-aged children

Prognosis of Pregnancy in Epileptics in Benin: A Case–Control Study

Behavioral Outcomes and Neurodevelopmental Disorders Among Children of Women With Epilepsy

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