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Clinical Summary

Periconceptional folate is tied to improved cognition in children of women with epilepsy

Takeaway

  • When women with epilepsy who were on antiseizure medication took folate ≥1 month before conception, their children scored higher on early intelligence testing in this prospective study.

Why this matters

Key results

  • Overall, 57% of the women took folate in the periconceptional period.
  • Periconceptional folate use was associated with a significantly higher Full Scale Intelligence Quotient:
    • At age 3 years: coefficient, 4.6 (P=.040).
    • At age 6 years coefficient, 5.9 (P=.001).
  • Other significant beneficial effects at age 3 years:
    • Verbal Index: coefficient, 3.8 (P=.050).
    • Receptive Language Index: coefficient, 4.6 (P=.019).
  • Other significant beneficial effects at age 6 years:
    • Nonverbal Index: coefficient, 3.1 (P=.028).
    • Expressive Language Index: coefficient, 3.3 (P=.049).
    • Developmental Neuropsychological Assessment Executive Function: coefficient, 3.9 (P=.018).

Study design

  • Multicenter prospective observational cohort study of 311 children of 305 women with epilepsy treated with single antiseizure medications (NEAD study).
  • Main outcomes: cognitive measures in children at 3 and 6 years of age.
  • Funding: NIH; United Kingdom Epilepsy Research Foundation.

Limitations

  • Fairly small, nonpopulation-based sample.
  • Losses to follow-up.
  • Nonrandomized design.
  • Pharmacokinetic measures not obtained.
  • Lack of unexposed control group.
  • Periconceptional folate use was ascertained from recall.

References


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