Evidence map›Paper›PMID 33345345›Full record

ArticleEpilepsia2020

Enduring language deficits in children of women with epilepsy and the potential role of intrauterine exposure to antiepileptic drugs.

Gopikrishnan Unnikrishnan, Nikita Susan Jacob, Salma Salim, Manna Jose, Reshma A Salini, Veena Pavithran, Panniyammakal Jeemon, Sanjeev V Thomas

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Article in Epilepsia, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
3.3field-weighted citation impact, top 8% 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

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 19 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Gopikrishnan UnnikrishnanDepartment of Neurology, Kerala Registry of Epilepsy and Pregnancy, Trivandrum, India.ORCID 0000-0003-1023-7098
Nikita Susan JacobDepartment of Neurology, Kerala Registry of Epilepsy and Pregnancy, Trivandrum, India.
Salma SalimDepartment of Neurology, Kerala Registry of Epilepsy and Pregnancy, Trivandrum, India.
Manna JoseDepartment of Neurology, Kerala Registry of Epilepsy and Pregnancy, Trivandrum, India.
Reshma A SaliniDepartment of Neurology, Kerala Registry of Epilepsy and Pregnancy, Trivandrum, India.
Veena PavithranDepartment of Neurology, Kerala Registry of Epilepsy and Pregnancy, Trivandrum, India.
Panniyammakal JeemonAchutha Menon Center for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.
Sanjeev V ThomasDepartment of Neurology, Kerala Registry of Epilepsy and Pregnancy, Trivandrum, India.ORCID 0000-0001-5307-3551
Pallium India · INSree Chitra Thirunal Institute for Medical Sciences and Technology · IN

Funding

Indian Council of Medical Research SCTIEC/17/ICMR NCD 1 /2006-2010
6 · The paper itself

Abstract

objectiveExposure to certain intrauterine antiepileptic drugs (AEDs) can negatively influence the language skills and intelligence of young children. It remains unanswered whether these deficits are transient or persist as children grow up. This study aims to evaluate the language function of children of women with epilepsy (CWE) aged 9-13 years in comparison with their peers, and its relationship with intrauterine AED exposure.

methodsWe included 191 CWE in our study from the Kerala Registry of Epilepsy and Pregnancy. Children in the same age group (n = 144) and without maternal epilepsy or antenatal AED exposure served as controls. We used Clinical Examination for Language Function version IV to assess language in both groups. Relevant data related to maternal epilepsy and AED use were obtained from the registry records.

resultsThe average Core Language Scaled Score (CLSS) was significantly lower in CWE as compared to controls (83.19 vs 90.18, P = .001). Similarly, the mean scaled scores in other language parameters were also significantly lower in CWE. In the multivariate analysis, compared to control children, the average CLSS in CWE was 4.5 units lower (95% confidence interval [CI] = -8.8 to -0.2, P = .04) with AED monotherapy exposure and 7.3 units lower with exposure to AED polytherapy (95% CI = -13.8 to -0.8, P = .03). Intrauterine exposure to phenobarbitone (n = 61) and valproate (n = 55) as either monotherapy or polytherapy showed a negative effect on CLSS in CWE as compared to control children. However, carbamazepine (n = 75) and phenytoin (n = 37) use was not associated with significant variation of CLSS. In head-to-head comparisons between AED monotherapies in CWE, phenobarbitone showed a negative effect on CLSS (-14.7, 95% CI = -23.1 to -6.4, P = .001) as compared to carbamazepine. SIGNIFICANCE: Intrauterine exposure to phenobarbitone and valproate impairs language development in CWE, with effects persisting into the second decade.

Indexed as

AdolescentAdultAnticonvulsantsChildEpilepsyFemaleFollow-Up StudiesHumansLanguage Development DisordersMalePregnancyPregnancy ComplicationsPrenatal Exposure Delayed EffectsProspective StudiesAnticonvulsantsantenatalantiepileptic drugepilepsyintrauterine exposurelanguage functionpregnancy

Identifiers

PMID33345345
OpenAlexW3094580226

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Registered trials

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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.