Developmental Effects On Children Of Women Who Take Antiepileptic Drugs During Pregnancy

NCT ID: NCT00021866

Last Updated: 2013-11-11

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

331 participants

Study Classification

OBSERVATIONAL

Study Start Date

2000-09-30

Study Completion Date

2012-08-31

Brief Summary

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The purpose of this study is to determine if antiepileptic drugs (AEDs) differ in their neurodevelopmental effects. Specifically, do the children of the women with epilepsy differ in their behavioral and cognitive development depending on which AED their mother takes during pregnancy?

Detailed Description

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This is a prospective investigation enrolling 285 to 380 women with epilepsy during the first two trimesters of their pregnancies. There are 25 clinical centers as well as the database center. The women will be taking one of the following AEDs: carbamazepine, phenytoin, valproate, or lamotrigine. Cognitive and behavioral testing of the child will be done up to the age of 6 years. The study does not change the woman's doctor and does not interfere with the care of the treating physician.

Conditions

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Epilepsy Seizure Cognition Disorders

Keywords

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epilepsy seizure pregnancy antiepileptic AED carbamazepine phenytoin valproate lamotrigine child behavior

Study Design

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Observational Model Type

FAMILY_BASED

Study Time Perspective

PROSPECTIVE

Study Groups

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Carbamazepine

Children and their mothers exposed to Carbamazepine monotherapy in utero

Differential Abilities Scale

Intervention Type BEHAVIORAL

IQ measurement at 3, 4.5 and 6 years of age

Neuropsychological Testing

Intervention Type BEHAVIORAL

Tests of memory, attention, and behavior administered at 2,3, 4.5 and 6 Years of age

Phenytoin

Children and their mothers exposed to phenytoin in utero

Differential Abilities Scale

Intervention Type BEHAVIORAL

IQ measurement at 3, 4.5 and 6 years of age

Neuropsychological Testing

Intervention Type BEHAVIORAL

Tests of memory, attention, and behavior administered at 2,3, 4.5 and 6 Years of age

Lamotrigine

Children and their mothers exposed to Lamotrigine in utero

Differential Abilities Scale

Intervention Type BEHAVIORAL

IQ measurement at 3, 4.5 and 6 years of age

Neuropsychological Testing

Intervention Type BEHAVIORAL

Tests of memory, attention, and behavior administered at 2,3, 4.5 and 6 Years of age

Valproate

Children and their mothers exposed to Valproate in utero

Differential Abilities Scale

Intervention Type BEHAVIORAL

IQ measurement at 3, 4.5 and 6 years of age

Neuropsychological Testing

Intervention Type BEHAVIORAL

Tests of memory, attention, and behavior administered at 2,3, 4.5 and 6 Years of age

Interventions

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Differential Abilities Scale

IQ measurement at 3, 4.5 and 6 years of age

Intervention Type BEHAVIORAL

Neuropsychological Testing

Tests of memory, attention, and behavior administered at 2,3, 4.5 and 6 Years of age

Intervention Type BEHAVIORAL

Other Intervention Names

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DAS (Toni-3) Test of Nonverbal Intelligence (WAIS) - Wechslers Adult Intelligence Scale -revised Beck Depression Inventory Bayley Scales of Infant Development, NEPSY Trails Preschool Preschool Language Scale-4 Expressive One-Word Vocabulary TEst Peabody Picture Vocabulary Test Developmental Test of Visual-Motor Integration Children's Memory Scale Grooved Pegboard Bracken Basic Concepts Scale Wide Range Achievement TEst Adaptive Behavior Assessment Scale Behavioral Assessment for Children Parenting Stress Index

Eligibility Criteria

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Inclusion Criteria

* Subject must be diagnosed with partial seizures and/or secondary generalization or primary generalized seizures (absence, atonic, myoclonic, and generalized tonic-clonic seizures)
* Subjects must be on either carbamazepine, lamotrigine, phenytoin, or valproate monotherapy.
* Mothers must not have a history of drug abuse (including alcohol) in the last year and have no sequelae of drug abuse.
* Mothers must be able to maintain an accurate seizure diary of major motor seizures
* Subjects must have an IQ greater than or equal to 70 points.
* Subjects must have a history of a negative RPR and HIV.
* Subjects must not have progressive cerebral disease or presence of other major medical illness
* Subjects must not have exposure to known teratogens during pregnancy, except AEDs.
* Subjects must not have poor compliance with prenatal care.
* Subjects must have adequate reading skills to perform the cognitive tests.
Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Neurological Disorders and Stroke (NINDS)

NIH

Sponsor Role collaborator

Emory University

OTHER

Sponsor Role lead

Responsible Party

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Kimford J. Meador, MD

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Kimford J. Meador, M.D.

Role: PRINCIPAL_INVESTIGATOR

Emory University, Atlanta

Locations

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University of Alabama

Birmingham, Alabama, United States

Site Status

Arizona Health Sciences

Tucson, Arizona, United States

Site Status

University of Southern California

Los Angeles, California, United States

Site Status

Georgetown University

Washington D.C., District of Columbia, United States

Site Status

Emory University

Atlanta, Georgia, United States

Site Status

Medical College of Georgia

Augusta, Georgia, United States

Site Status

RUSH University Medical Center

Chicago, Illinois, United States

Site Status

Via Christi Medical Center

Wichita, Kansas, United States

Site Status

Brigham & Womens' Hospital

Boston, Massachusetts, United States

Site Status

Henry Ford Hospital

Detroit, Michigan, United States

Site Status

Minnesota Epilepsy Group

Saint Paul, Minnesota, United States

Site Status

Columbia University

New York, New York, United States

Site Status

Wake Forest University Baptist Medical Center

Winston-Salem, North Carolina, United States

Site Status

University of Cincinnati

Cincinnati, Ohio, United States

Site Status

Case Western Reserve University

Cleveland, Ohio, United States

Site Status

Ohio State University

Columbus, Ohio, United States

Site Status

Riddle Health Care II

Media, Pennsylvania, United States

Site Status

Baylor Medical Center

Irving, Texas, United States

Site Status

University of Utah

Salt Lake City, Utah, United States

Site Status

University of Washington

Seattle, Washington, United States

Site Status

University of Liverpool

Liverpool, , United Kingdom

Site Status

Countries

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United States United Kingdom

References

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Meador KJ, Chadwick D, Clayton-Smith J, Pennell P, Liporace J, Kalayian L, and NEAD Study Group. Antiepileptic drugs in pregnancy: Differences in U.K. and U.S.A. Epilepsia, 2003;44 (Suppl. 9):289.

Reference Type RESULT

Meador KJ, Page P, Liporace J, Kalayjian L, NEAD Study Group. Antiepileptic Drugs in Pregnancy. Neurology 2004;62 (Suppl 5):A311.

Reference Type RESULT

Meador KJ, Baker GA, Clayton Smith J, Pennell P, Liporace J, Kalayjian L, Kini U, NEAD Study Group. Differential Effects of Antiepileptic Drugs on Serious Adverse Outcomes in Children Exposed In Utero. Epilepsia 2004;45 (Suppl 3):58

Reference Type RESULT

Meador KM, Loring DW, Baker G, Smith JC, Pennell P, Liporace J, Kalayjian L, Kini U, NEAD Study Group. Differential and dose dependent effects of in utero antiepileptic drugs. Neurology 2005;64 (Suppl 1):A427

Reference Type RESULT

Meador KJ, Baker GA, Finnell RH, Kalayjian LA, Liporace JD, Loring DW, Mawer G, Pennell PB, Smith JC, Wolff MC; NEAD Study Group. In utero antiepileptic drug exposure: fetal death and malformations. Neurology. 2006 Aug 8;67(3):407-12. doi: 10.1212/01.wnl.0000227919.81208.b2.

Reference Type RESULT
PMID: 16894099 (View on PubMed)

Meador KJ, Pennell PB, May RC, Brown CA, Baker G, Bromley R, Loring DW, Cohen MJ; NEAD Investigator Group. Effects of periconceptional folate on cognition in children of women with epilepsy: NEAD study. Neurology. 2020 Feb 18;94(7):e729-e740. doi: 10.1212/WNL.0000000000008757. Epub 2019 Dec 23.

Reference Type DERIVED
PMID: 31871217 (View on PubMed)

Meador KJ, Baker GA, Browning N, Cohen MJ, Bromley RL, Clayton-Smith J, Kalayjian LA, Kanner A, Liporace JD, Pennell PB, Privitera M, Loring DW; Neurodevelopmental Effects of Antiepileptic Drugs (NEAD) Study Group. Breastfeeding in children of women taking antiepileptic drugs: cognitive outcomes at age 6 years. JAMA Pediatr. 2014 Aug;168(8):729-36. doi: 10.1001/jamapediatrics.2014.118.

Reference Type DERIVED
PMID: 24934501 (View on PubMed)

Meador KJ, Baker GA, Browning N, Cohen MJ, Bromley RL, Clayton-Smith J, Kalayjian LA, Kanner A, Liporace JD, Pennell PB, Privitera M, Loring DW; NEAD Study Group. Fetal antiepileptic drug exposure and cognitive outcomes at age 6 years (NEAD study): a prospective observational study. Lancet Neurol. 2013 Mar;12(3):244-52. doi: 10.1016/S1474-4422(12)70323-X. Epub 2013 Jan 23.

Reference Type DERIVED
PMID: 23352199 (View on PubMed)

Related Links

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https://web.emmes.com/study/monead

Click here for more information about this study and a list of recruiting centers

Other Identifiers

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2R01NS038455

Identifier Type: NIH

Identifier Source: secondary_id

View Link

2R01NS038455-06

Identifier Type: NIH

Identifier Source: secondary_id

View Link

0334-2001

Identifier Type: -

Identifier Source: org_study_id