Evidence map›Paper›PMID 31871217›Full record

Observational studyNeurology2020

Effects of periconceptional folate on cognition in children of women with epilepsy: NEAD study.

Kimford J Meador, Page B Pennell, Ryan C May, Carrie A Brown, Gus Baker, Rebecca Bromley, David W Loring, Morris J Cohen, NEAD Investigator Group

Registry-linked trialOpen access · bronzeAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00021866 (Neurodevelopmental Effects of Antiepileptic Drugs II), which is not on this map. Cited by 29 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 2 pooled it
9.8field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00021866 completednot on this map

Neurodevelopmental Effects of Antiepileptic Drugs II: the NEAD Study

TypeobservationalSponsorEmory UniversityRan2000 to 2012Enrolled331ConditionsEpilepsy, Seizure, Cognition DisordersArmsDifferential Abilities Scale, Neuropsychological Testing
3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 72 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Observational
  4. Review
  5. Review
  6. Review
  7. Article
  8. Epilepsy in women of childbearing age: a focused review.Neurological research and practice · 2025
    Review
  9. Article
  10. [Epilepsy and pregnancy].Der Nervenarzt · 2024
    Review
  11. Article
  12. Article
  13. Article
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  15. Article
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  20. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 2 countries.

Kimford J MeadorFrom the Department of Neurology and Neurological Sciences (K.J.M.), Stanford University, CA; Department of Neurology (P.B.P.), Brigham and Women's Hospital, Harvard Medical School, Boston; The Emmes Corporation (R.C.M., C.A.B.), Rockville, MD; Walton Centre for Neurology & Neurosurgery (G.B.), University of Liverpool, Merseyside; Division of Evolution and Genomic Science (R.B.), School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK; Departments of Neurology and Pediatrics (D.W.L.), Emory University, Atlanta; and Pediatric Neuropsychology International (M.J.C.), Augusta, GA. kmeador@stanford.edu.
Page B PennellFrom the Department of Neurology and Neurological Sciences (K.J.M.), Stanford University, CA; Department of Neurology (P.B.P.), Brigham and Women's Hospital, Harvard Medical School, Boston; The Emmes Corporation (R.C.M., C.A.B.), Rockville, MD; Walton Centre for Neurology & Neurosurgery (G.B.), University of Liverpool, Merseyside; Division of Evolution and Genomic Science (R.B.), School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK; Departments of Neurology and Pediatrics (D.W.L.), Emory University, Atlanta; and Pediatric Neuropsychology International (M.J.C.), Augusta, GA.
Ryan C MayFrom the Department of Neurology and Neurological Sciences (K.J.M.), Stanford University, CA; Department of Neurology (P.B.P.), Brigham and Women's Hospital, Harvard Medical School, Boston; The Emmes Corporation (R.C.M., C.A.B.), Rockville, MD; Walton Centre for Neurology & Neurosurgery (G.B.), University of Liverpool, Merseyside; Division of Evolution and Genomic Science (R.B.), School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK; Departments of Neurology and Pediatrics (D.W.L.), Emory University, Atlanta; and Pediatric Neuropsychology International (M.J.C.), Augusta, GA.
Carrie A BrownFrom the Department of Neurology and Neurological Sciences (K.J.M.), Stanford University, CA; Department of Neurology (P.B.P.), Brigham and Women's Hospital, Harvard Medical School, Boston; The Emmes Corporation (R.C.M., C.A.B.), Rockville, MD; Walton Centre for Neurology & Neurosurgery (G.B.), University of Liverpool, Merseyside; Division of Evolution and Genomic Science (R.B.), School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK; Departments of Neurology and Pediatrics (D.W.L.), Emory University, Atlanta; and Pediatric Neuropsychology International (M.J.C.), Augusta, GA.
Gus BakerFrom the Department of Neurology and Neurological Sciences (K.J.M.), Stanford University, CA; Department of Neurology (P.B.P.), Brigham and Women's Hospital, Harvard Medical School, Boston; The Emmes Corporation (R.C.M., C.A.B.), Rockville, MD; Walton Centre for Neurology & Neurosurgery (G.B.), University of Liverpool, Merseyside; Division of Evolution and Genomic Science (R.B.), School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK; Departments of Neurology and Pediatrics (D.W.L.), Emory University, Atlanta; and Pediatric Neuropsychology International (M.J.C.), Augusta, GA.
Rebecca BromleyFrom the Department of Neurology and Neurological Sciences (K.J.M.), Stanford University, CA; Department of Neurology (P.B.P.), Brigham and Women's Hospital, Harvard Medical School, Boston; The Emmes Corporation (R.C.M., C.A.B.), Rockville, MD; Walton Centre for Neurology & Neurosurgery (G.B.), University of Liverpool, Merseyside; Division of Evolution and Genomic Science (R.B.), School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK; Departments of Neurology and Pediatrics (D.W.L.), Emory University, Atlanta; and Pediatric Neuropsychology International (M.J.C.), Augusta, GA.
David W LoringFrom the Department of Neurology and Neurological Sciences (K.J.M.), Stanford University, CA; Department of Neurology (P.B.P.), Brigham and Women's Hospital, Harvard Medical School, Boston; The Emmes Corporation (R.C.M., C.A.B.), Rockville, MD; Walton Centre for Neurology & Neurosurgery (G.B.), University of Liverpool, Merseyside; Division of Evolution and Genomic Science (R.B.), School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK; Departments of Neurology and Pediatrics (D.W.L.), Emory University, Atlanta; and Pediatric Neuropsychology International (M.J.C.), Augusta, GA.
Morris J CohenFrom the Department of Neurology and Neurological Sciences (K.J.M.), Stanford University, CA; Department of Neurology (P.B.P.), Brigham and Women's Hospital, Harvard Medical School, Boston; The Emmes Corporation (R.C.M., C.A.B.), Rockville, MD; Walton Centre for Neurology & Neurosurgery (G.B.), University of Liverpool, Merseyside; Division of Evolution and Genomic Science (R.B.), School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK; Departments of Neurology and Pediatrics (D.W.L.), Emory University, Atlanta; and Pediatric Neuropsychology International (M.J.C.), Augusta, GA.
NEAD Investigator Group
Brigham and Women's Hospital · USStanford University · USWalton Centre · GBEmory University · USUniversity of Liverpool · GB

Funding

The Harvard Clinical and Translational Science CenterUL1TR002541 · NCATS · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2018 to 2022
$93.0M
Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD)U01NS038455 · NINDS · STANFORD UNIVERSITY · PI MATTHEWS, ABIGAIL GOREN, MEADOR, KIMFORD J · 2012 to 2022
$27.7M
NEURODEVELOPMENT EFFECTS OF ANTIEPILEPTIC DRUGSR01NS038455 · NINDS · UNIVERSITY OF FLORIDA · PI MEADOR, KIMFORD J · 2000 to 2009
$12.0M
NCATS NIH HHS UL1 TR002541NINDS NIH HHS R01 NS038455NINDS NIH HHS U01 NS038455
6 · The paper itself

Abstract

objectiveEmerging evidence suggests potential positive neuropsychological effects of periconceptional folate in both healthy children and children exposed in utero to antiseizure medications (ASMs). In this report, we test the hypothesis that periconceptional folate improves neurodevelopment in children of women with epilepsy by re-examining data from the Neurodevelopmental Effects of Antiepileptic Drugs (NEAD) study.

methodsThe NEAD study was an NIH-funded, prospective, observational, multicenter investigation of pregnancy outcomes in 311 children of 305 women with epilepsy treated with ASM monotherapy. Missing data points were imputed with Markov chain Monte Carlo methods. Multivariate analyses adjusted for multiple factors (e.g., maternal IQ, ASM type, standardized ASM dose, and gestational birth age) were performed to assess the effects of periconceptional folate on cognitive outcomes (i.e., Full Scale Intelligence Quotient [FSIQ], Verbal and Nonverbal indexes, and Expressive and Receptive Language indexes at 3 and 6 years of age, and executive function and memory function at 6 years of age).

resultsPericonceptional folate was associated with higher FSIQ at both 3 and 6 years of age. Significant effects for other measures included Nonverbal Index, Expressive Language Index, and Developmental Neuropsychological Assessment Executive Function at 6 years of age, and Verbal Index and Receptive Language Index at 3 years of age. Nonsignificant effects included Verbal Index, Receptive Index, Behavior Rating Inventory of Executive Function-Parent Questionnaire Executive Function, and General Memory Index at 6 years of age, and Nonverbal Index and Expressive Index at 3 years of age.

conclusionsUse of periconceptional folate in pregnant women with epilepsy taking ASMs is associated with better cognitive development. CLINICALTRIALSGOV IDENTIFIER: NCT00021866.

Indexed as

AdultAnticonvulsantsChildChild, PreschoolCognitionEpilepsyFemaleFolic AcidHumansPregnancyPregnancy ComplicationsPrenatal Exposure Delayed EffectsProspective StudiesProtective AgentsAnticonvulsantsFolic AcidProtective Agents

Identifiers

PMID31871217
PMCPMC7176294
OpenAlexW2995458520

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.