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Valproate epilepsy drug could lower babies IQ

Mothers with epilepsy are able to have perfectly healthy children, ongoing research suggests however that sodium valproate, or just, “Valproate” taken by the epileptic mother, may lower a babies IQ.

Women with epilepsy usually need to keep taking their epilepsy drugs while pregnant, research suggests that some drugs could have harmful effects on the baby. The drugs are already known to transfer into the babies bloodstream, and there seems to be a higher risk of birth defects for babies if their mother has epilepsy. An ongoing study has suggested that birth defects are more common with sodium valproate (sometimes just called Valproate) which has been used for many years to prevent seizures.

The study measured the intelligence quotients (IQs) of 309 3-year-old children whose mothers had taken anti-seizure drugs for epilepsy while they were pregnant. It found that children whose mothers had taken lamotrigine, phenytoin, and carbamazepine had higher IQ scores than children whose mothers had taken valproate. Scores for children whose mothers had taken valproate were on average 6 to 9 points lower. The average person has an IQ of 100, with about half the population scoring between 90 and 110.

Usually, the main factor that predicts a child’s IQ is the IQ score of his or her mother. This was true of the children taking other anti-epilepsy drugs, but not for children taking valproate. This suggests that valproate made a real difference to what happened to the children. The effects on IQ were more noticeable when women were taking higher doses of valproate.

This study is part of a longer-term study. The researchers will complete their work when the children are aged 6.

Talk to your doctor about how your epilepsy should be treated while you’re pregnant, or trying to get pregnant. Your doctor can help you make sure you’re on the type of medicine that best controls your seizures, at the lowest dose. Your doctor might suggest you change to a different type of medicine, or to a lower dose, before you get pregnant.

He or she can also advise you about the dose of folic acid you need to take. Folic acid helps protect the growing baby against birth defects. If at all possible, speak to your doctor six months before you plan to start trying for a baby. That means you’ll have time to sort out any problems with changes to your medicine.

If you’d like to help doctors find out more about the effects of epilepsy drugs in pregnancy, you can register your pregnancy with the UK Epilepsy and Pregnancy Register (http://www.epilepsyandpregnancy.co.uk).

From:

Kimford J. Meador MD, Baker GA, et al. Cognitive function at 3 years of age after fetal exposure to antiepileptic drugs. New England Journal of Medicine. 2009;360:1597-1605.

         

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Premature babies on antibiotics are at risk of becoming deaf

Genetic researchers at the Institute of Child Health in London revealed a report claiming that antibiotics used to treat infections in premature babies put them at a high risk of turning deaf.

The prime antibiotic in focus is aminoglycosides. Aminoglycosides, categorised as “broad spectrum” drugs, are powerful antibiotics used to treat infections in premature babies. These antiobiotics are widely used because they are effective and cheap.

Published in the ‘New England Journal of Medicine’, the study warns that children with an inherited sensitivity to very potent antibiotics might leave them with a lifelong and irreversible hearing disability. This sensitivity can be blamed on genetic mutations found in some individuals.

Infections in children with cancer and other chronic medical conditions including tuberculosis, septicemia, complicated urinary tract infections and cystic fibrosis are usually treated with these sets of antibiotics, which are used for adults as well.

This category of extremely powerful antibiotics is known to cause permanent damage to the ear (otoxicity) and hearing ability.

Aminoglycosides cannot be prescribed by a GP and is used widely in premature baby units in hospitals. It is administered with the help of injection in patients. Researchers agree that if some families are carrying this mutation, they may experience hearing loss even when they are not exposed to aminoglycosides.

The researchers studied blood samples of more than 9,000 children. They observed that one in every 500 children had a genetic mutation called m.1555A-G mutation, which had made them more susceptible to the aminoglycosides causing deafness.

Research Lead Maria Bitner-Glindzicz, a consultant geneticist said, “All (the affected children) are permanently deaf. It is possible there are more children with a lesser degree of hearing loss who have not come to the notice of doctors. Adults can also be affected. If you have this mutation and get this class of antibiotics, they have this rapid and extreme effect.”

Bitner-Glindzicz and her colleagues explained that children must be screened beforehand to detect the mutation before injecting aminoglycosides. However, they agree that in emergency cases patient might have to be given antibiotics immediately.

“Waiting for a gene test may sometimes not be clinically right, particularly on neonatal units. Universal pre-natal testing of mothers should be considered for this reason,” said Bitner-Glindzicz.

“It was known a side effect was hearing loss, but if doctors found a case of hearing loss in a premature baby, they tended to ascribe it to prematurity or that the dose of antibiotics was too high,” she quoted. “Now we have established it is to do with genetic susceptibility, and it affects one in 500 babies.”

According to Bitner-Glindzicz, screening pregnant women for this mutation is very essential to protect children from such risks and these tests must be made mandatory. Almost 20,000 babies are treated with aminoglycosides every year.