Evidence map›Paper›PMID 41553327›Full record

ArticleEpilepsia2026

Development of cerebral lateralization in children exposed to fetal antiseizure medications: A prospective cohort study at age 6 years.

Yi Li, David W Loring, Morris J Cohen, Abigail G Matthews, Angela K Birnbaum, Page B Pennell, Kimford J Meador, Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs Investigator Group

Abstract readMulticenter Study
In one paragraph

Article in Epilepsia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Yi LiStanford University, Palo Alto, California, USA.ORCID https://orcid.org/0000-0003-0392-6661
David W LoringSchool of Medicine, Emory University, Atlanta, Georgia, USA.ORCID https://orcid.org/0000-0003-2497-1074
Morris J CohenPediatric Neuropsychology International, Augusta, Georgia, USA.ORCID https://orcid.org/0009-0001-3402-8015
Abigail G MatthewsEmmes Company, Rockville, Maryland, USA.ORCID https://orcid.org/0000-0003-1997-9194
Angela K BirnbaumUniversity of Minnesota, Minneapolis, Minnesota, USA.ORCID https://orcid.org/0000-0002-3969-4906
Page B PennellSchool of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.ORCID https://orcid.org/0000-0003-0568-2795
Kimford J MeadorStanford University, Palo Alto, California, USA.ORCID https://orcid.org/0000-0002-7471-882X
Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs Investigator Group

Funding

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
Mapping Genetic Pathways Associated With Neurodevelopmental Variability after Fetal Anti-Seizure Medication ExposureK23NS136771 · NINDS · STANFORD UNIVERSITY · PI Yi Li · 2025 to 2026
$457k
NINDS NIH HHS 2U01-NS038455NINDS NIH HHS K23 NS136771NINDS NIH HHS R01 NS038455NINDS NIH HHS U01 NS038455NINDS NIH HHS U01-NS038455NINDS NIH HHS U01-NS050659
6 · The paper itself

Abstract

objectiveWe previously reported in a prior cohort that fetal exposure to antiseizure medications (ASMs), especially valproate, was associated with reduced right-handedness and poorer verbal versus nonverbal performance in children at age 6 years. Given changes in prescribing practices in epilepsy over the past 2 decades, we enrolled a new cohort of the Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD) study to determine whether fetal exposure to newer generation ASMs is associated with altered cerebral lateralization in children at age 6 years and to assess exposure-dependent effects on handedness, manual dexterity, and verbal/nonverbal abilities.

methodsThe MONEAD multicenter prospective cohort study followed children of women with epilepsy (WWE) on ASMs and healthy women (HW) until age 6 years. We assessed handedness using the Edinburgh Handedness Inventory, manual dexterity through the Grooved Pegboard Test, and verbal/nonverbal abilities with the Differential Ability Scales-II. Outcomes were analyzed in relation to ASM exposure, controlling for confounders.

resultsOf 1123 screened pregnant women, 351 children born to WWE and 105 to HW were enrolled. The overall distribution of handedness and verbal/nonverbal scores did not differ between groups. However, subgroup analyses revealed that higher third-trimester levetiracetam concentrations were significantly associated with nondextrality (p = .03, 95% confidence interval [CI] = .03-.67). Across the WWE cohort, higher ASM concentrations correlated with poorer manual dexterity (coefficient = 6.76, 95% CI = .40-13.11, p = .037). Additionally, periconceptional folate supplementation was associated with better nonverbal outcomes (coefficient = 2.54, 95% CI = .93-4.15, p = .002) and parental stress was linked to poorer verbal scores (coefficient = -19.74, 95% CI = -28.48 to -11, p < .001). SIGNIFICANCE: This cohort reassuringly showed no overall difference in verbal/nonverbal abilities between WWE and HW. Fetal ASM exposure had exposure-dependent effects on manual dexterity. Modifiable factors, including folate supplementation and parental stress, significantly influenced developmental outcomes, underscoring the importance of proactive screening and providing intervention when appropriate.

Indexed as

AnticonvulsantsEpilepsyFunctional LateralityPrenatal Exposure Delayed EffectsAdultChildChild, PreschoolCohort StudiesFemaleHumansInfantMalePregnancyProspective StudiesValproic AcidAnticonvulsantsValproic Acidantiseizure medicationsbrain lateralizationfetalfolatehandednesslanguage

Identifiers

PMID41553327
PMCPMC13333143

What Socratic holds

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Registered trials

None linked

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 Socratic graph.