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Article ; Online: Neurodevelopment Following Exposure to Antiseizure Medications in Utero: A Review.

Bromley, Rebecca L / Bluett-Duncan, Matthew

2021 Volume 19, Issue 11, Page(s) 1825–1834

Abstract: Exposure in the womb to antiseizure medications and their potential impact on the brain of the developing child has long been researched. Despite this long period of interest, this review highlights that above the well-known risks associated with ... ...

Abstract	Exposure in the womb to antiseizure medications and their potential impact on the brain of the developing child has long been researched. Despite this long period of interest, this review highlights that above the well-known risks associated with valproate exposure, there are more data required for conclusions regarding all other antiseizure medications. Limited experience with phenytoin and phenobarbital in monotherapy makes clearly defining the risk to later child postnatal functioning difficult, although the evidence of an impact is stronger for phenobarbital than for phenytoin. The widely prescribed lamotrigine is limited in its investigation in comparison to unexposed control children, and whilst it has been demonstrated to carry a lower risk than valproate for certain outcomes, whether it is associated with a more moderate impact on wider aspects of neurodevelopmental functioning is still to be understood. Data for levetiracetam, topiramate and oxcarbazepine are too limited to confidently draw conclusions for most neurodevelopmental outcomes. This slow accumulation of evidence impacts on the safest use of medications in pregnancy and makes counseling women regarding the risks and benefits of specific antiseizure medications difficult. Improved focus, funding, and research methodologies are urgently needed.
MeSH term(s)	Anticonvulsants/adverse effects ; Child ; Epilepsy/drug therapy ; Female ; Humans ; Lamotrigine/therapeutic use ; Oxcarbazepine/therapeutic use ; Pregnancy ; Pregnancy Complications/drug therapy
Chemical Substances	Anticonvulsants ; Lamotrigine (U3H27498KS) ; Oxcarbazepine (VZI5B1W380)
Language	English
Publishing date	2021-07-19
Publishing country	United Arab Emirates
Document type	Journal Article ; Review
ZDB-ID	2192352-8
ISSN	1875-6190 ; 1570-159X
ISSN (online)	1875-6190
ISSN	1570-159X
DOI	10.2174/1570159X19666210716111814
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Article ; Online: An inventory of European data sources to support pharmacoepidemiologic research on neurodevelopmental outcomes in children following medication exposure in pregnancy: A contribution from the ConcePTION project.

Given, Joanne / Bromley, Rebecca L / Coste, Florence / Lopez-Leon, Sandra / Loane, Maria

PloS one

2022 Volume 17, Issue 10, Page(s) e0275979

Abstract: Background: Studies on medication safety in pregnancy are increasingly focusing on child neurodevelopmental outcomes. Establishing neurodevelopmental safety is complex due to the range of neurodevelopmental outcomes and the length of follow-up needed ... ...

Abstract	Background: Studies on medication safety in pregnancy are increasingly focusing on child neurodevelopmental outcomes. Establishing neurodevelopmental safety is complex due to the range of neurodevelopmental outcomes and the length of follow-up needed for accurate assessment. The aim of this study was to provide an inventory of European data sources for use in pharmacoepidemiologic studies investigating neurodevelopment following maternal medication exposure. Method: The EUROmediSAFE inventory of data sources in Europe for evaluating perinatal and long-term childhood risks associated with in-utero exposure to medication was updated by contacting colleagues across 31 European countries, literature review and internet searches. Included data sources must record at least one neurodevelopmental outcome and maternal medication use in pregnancy must be available, either in the data source itself or through linkage with another data source. Information on the domain of neurodevelopment, measure/scale used and the approach to measurement were recorded for each data source. Results: Ninety data sources were identified across 14 countries. The majority (63.3%) were created for health surveillance and research with the remaining serving administrative purposes (21.1% healthcare databases,15.6% other administrative databases). Five domains of neurodevelopment were identified-infant development (36 data sources,13 countries), child behaviour (27 data sources, 10 countries), cognition (29 data sources, 12 countries), educational achievement (20 data sources, 7 countries), and diagnostic codes for neurodevelopmental disorders (42 data sources, 11 countries). Thirty-nine data sources, in 12 countries, had information on more than one domain of neurodevelopment. Conclusion: This inventory is invaluable to future studies planning to investigate the neurodevelopmental impact of medication exposures during pregnancy. Caution must be used when combining varied approaches to neurodevelopment outcome measurement, the age of children in the data source, and the sensitivity and specificity of the outcome measure selected should be borne in mind.
MeSH term(s)	Child ; Child Development ; Cognition ; Female ; Humans ; Infant ; Information Storage and Retrieval ; Maternal Exposure/adverse effects ; Neurodevelopmental Disorders/chemically induced ; Neurodevelopmental Disorders/epidemiology ; Pregnancy
Language	English
Publishing date	2022-10-14
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0275979
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Article ; Online: Prenatal Exposure to Antiseizure Medications and Risk of Epilepsy in Children of Mothers With Epilepsy.

Dreier, Julie Werenberg / Christensen, Jakob / Igland, Jannicke / Gissler, Mika / Leinonen, Maarit K / Vegrim, Håkon Magne / Sun, Yuelian / Tomson, Torbjörn / Zoega, Helga / Bjørk, Marte-Helene / Bromley, Rebecca L

JAMA network open

2024 Volume 7, Issue 2, Page(s) e2356425

Abstract: Importance: Use of valproate and certain other antiseizure medications (ASMs) in pregnancy is associated with abnormal fetal brain development with potential long-term implications for the child.: Objective: To examine whether use of valproate and ... ...

Abstract	Importance: Use of valproate and certain other antiseizure medications (ASMs) in pregnancy is associated with abnormal fetal brain development with potential long-term implications for the child. Objective: To examine whether use of valproate and other ASMs in pregnancy among mothers with epilepsy is associated with epilepsy risk in their children. Design, setting, and participants: This prospective, population-based register cohort study included singletons born to mothers with epilepsy in Denmark, Finland, Iceland, Norway, and Sweden from January 1, 1996, to December 31, 2017. Data analysis was performed from October 2022 to December 2023. Exposure: Redeemed prescription for an ASM from 30 days before pregnancy until birth. Main outcomes and measures: The main outcome was epilepsy in children, assessed using International Statistical Classification of Diseases and Related Health Problems, Tenth Revision diagnoses from hospital care. Adjusted hazard ratios (AHRs) and 95% CIs were estimated using Cox proportional hazards regression. Secondary analyses included dose-response analyses, analyses using children of mothers who discontinued ASM prior to pregnancy as the reference, and sibling analyses. Results: This cohort study included 38 663 children of mothers with epilepsy (19 854 [51.4%] boys). Children were followed up from birth; the mean length of follow-up was 7.2 years (range 0-22 years). Compared with 22 207 children of mothers not using an ASM in pregnancy, increased risks of epilepsy in children of mothers who used valproate in pregnancy (monotherapy: AHR, 2.18; 95% CI, 1.70-2.79; polytherapy: AHR, 2.10; 95% CI, 1.49-2.96) were observed. However, there was no dose-dependent association, and there was a similar risk of epilepsy in siblings who were exposed and unexposed to valproate (AHR, 0.95; 95% CI, 0.50-1.82). Prenatal exposure to topiramate monotherapy was associated with increased risk of epilepsy (AHR, 2.32; 95% CI, 1.30-4.16), and the risk was greater for higher doses, but the risk attenuated in comparisons with children of mothers who discontinued topiramate before pregnancy (AHR, 1.19; 95% CI, 0.26-5.44). Prenatal exposure to clonazepam monotherapy was also associated with increased epilepsy risk (AHR, 1.90; 95% CI, 1.16-3.12), but limited follow-up and low numbers precluded further analyses. No associations were observed for prenatal exposure to lamotrigine (AHR, 1.18; 95% CI, 0.95-1.47), levetiracetam (AHR, 1.28; 95% CI, 0.77-2.14), carbamazepine (AHR, 1.13; 95% CI, 0.85-1.50), or oxcarbazepine (AHR, 0.68; 95% CI, 0.44-1.05). Conclusions and relevance: In this cohort study of children born to mothers with epilepsy, the associations found between prenatal exposure to certain ASMs and the child's risk of epilepsy did not persist in sensitivity analyses, suggesting that maternal ASM use in pregnancy may not increase epilepsy risk in children beyond that associated with the maternal epilepsy itself. These findings are reassuring for women in need of treatment with ASM in pregnancy.
MeSH term(s)	Male ; Child ; Pregnancy ; Humans ; Female ; Valproic Acid/adverse effects ; Topiramate ; Cohort Studies ; Prenatal Exposure Delayed Effects/epidemiology ; Prospective Studies ; Epilepsy/drug therapy ; Epilepsy/epidemiology ; Vitamins ; Mothers
Chemical Substances	Valproic Acid (614OI1Z5WI) ; Topiramate (0H73WJJ391) ; Vitamins
Language	English
Publishing date	2024-02-05
Publishing country	United States
Document type	Journal Article
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2023.56425
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Article ; Online: Fetal antiepileptic drug exposure and cognitive outcomes.

Bromley, Rebecca L / Baker, Gus A

Seizure

2016 Volume 44, Page(s) 225–231

Abstract: Purpose: Data highlighting valproate as a human teratogen put in context the need to balance both maternal and fetal needs; maximising maternal health whilst minimising fetal risk. This led to increased research efforts to understand the associated ... ...

Abstract	Purpose: Data highlighting valproate as a human teratogen put in context the need to balance both maternal and fetal needs; maximising maternal health whilst minimising fetal risk. This led to increased research efforts to understand the associated risks with AED treatments. Methods: A review of currently published literature was undertaken. Results: In utero exposure to valproate was associated with a range of poorer neurodevelopmental outcomes when compared to control children and children exposed to other antiepileptic drugs (AEDs). Children exposed to carbamazepine were not found by the majority of studies to have poorer early development, although there is a lack of evidence regarding specific cognitive skills later in childhood and adolescence. Research regarding lamotrigine was limited to a small number of studies but suggests early global development or school aged IQ does not differ from control children, but less is known about specific cognitive skills. Evidence for the other AEDs including levetiracetam and topiramate were significantly limited. Conclusions: Despite an improvement in momentum the evidence remains incomplete for neurodevelopmental outcomes and this limits evidence-based decision making. Further efforts are required to enhance the treatment of women by giving them the confidence that both the risks and the benefits of commonly used AEDs are known. Future research should also seek to increase our understanding of the children who experience neurodevelopmental difficulties in the context of exposure in the womb to AEDs and what interventions may be successful in maximising the outcome of these children.
MeSH term(s)	Anticonvulsants/adverse effects ; Cognition Disorders/etiology ; Developmental Disabilities/chemically induced ; Epilepsy/drug therapy ; Female ; Fetus ; Humans ; Male ; Pregnancy ; Pregnancy Complications/chemically induced ; Prenatal Exposure Delayed Effects/chemically induced
Chemical Substances	Anticonvulsants
Language	English
Publishing date	2016-10-14
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1137610-7
ISSN	1532-2688 ; 1059-1311
ISSN (online)	1532-2688
ISSN	1059-1311
DOI	10.1016/j.seizure.2016.10.006
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Article ; Online: Maternal Use of Antiepileptic Agents During Pregnancy and Major Congenital Malformations in Children.

Bromley, Rebecca L / Weston, Jennifer / Marson, Anthony G

JAMA

2017 Volume 318, Issue 17, Page(s) 1700–1701

Abstract: Clinical question: Is maternal use of antiepileptic drugs during pregnancy associated with major congenital malformations in children?: Bottom line: Certain antiepileptic drugs were associated with increased rates of congenital malformations (eg, ... ...

Abstract	Clinical question: Is maternal use of antiepileptic drugs during pregnancy associated with major congenital malformations in children? Bottom line: Certain antiepileptic drugs were associated with increased rates of congenital malformations (eg, spina bifida, cardiac anomalies). Lamotrigine (2.31% in 4195 pregnancies) and levetiracetam (1.77% in 817 pregnancies) were associated with the lowest risk and valproate was associated with the highest risk (10.93% in 2565 pregnancies) compared with the offspring of women without epilepsy (2.51% in 2154 pregnancies).
MeSH term(s)	Abnormalities, Drug-Induced ; Anticonvulsants/adverse effects ; Epilepsy/drug therapy ; Female ; Humans ; Infant, Newborn ; Pregnancy ; Pregnancy Complications/drug therapy ; Review Literature as Topic
Chemical Substances	Anticonvulsants
Language	English
Publishing date	2017-03-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	2958-0
ISSN	1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
ISSN (online)	1538-3598
ISSN	0254-9077 ; 0002-9955 ; 0098-7484
DOI	10.1001/jama.2017.14485
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Article ; Online: Implementation and evaluation of an elective quality improvement curriculum for preclinical students: a prospective controlled study.

Aredo, Jacqueline V / Ding, Jack B / Lai, Cara H / Trimble, Richard / Bromley-Dulfano, Rebecca A / Popat, Rita A / Shieh, Lisa

BMC medical education

2023 Volume 23, Issue 1, Page(s) 66

Abstract: Background: Quality improvement (QI) is a systematic approach to improving healthcare delivery with applications across all fields of medicine. However, exposure to QI is minimal in early medical education. We evaluated the effectiveness of an elective ... ...

Abstract	Background: Quality improvement (QI) is a systematic approach to improving healthcare delivery with applications across all fields of medicine. However, exposure to QI is minimal in early medical education. We evaluated the effectiveness of an elective QI curriculum in teaching preclinical health professional students foundational QI concepts. Methods: This prospective controlled cohort study was conducted at a single academic institution. The elective QI curriculum consisted of web-based video didactics and exercises, supplemented with in-person classroom discussions. An optional hospital-based QI project was offered. Assessments included pre- and post-intervention surveys evaluating QI skills and beliefs and attitudes, quizzes, and Quality Improvement Knowledge Application Tool-Revised (QIKAT-R) cases. Within-group pre-post and between-group comparisons were performed using descriptive statistics. Results: Overall, 57 preclinical medical or physician assistant students participated under the QI curriculum group (N = 27) or control group (N = 30). Twenty-three (85%) curriculum students completed a QI project. Mean quiz scores were significantly improved in the curriculum group from pre- to post-assessment (Quiz 1: 2.0, P < 0.001; Quiz 2: 1.7, P = 0.002), and the mean differences significantly differed from those in the control group (Quiz 1: P < 0.001; Quiz 2: P = 0.010). QIKAT-R scores also significantly differed among the curriculum group versus controls (P = 0.012). In the curriculum group, students had improvements in their confidence with all 10 QI skills assessed, including 8 that were significantly improved from pre- to post-assessment, and 4 with significant between-group differences compared with controls. Students in both groups agreed that their medical education would be incomplete without a QI component and that they are likely to be involved in QI projects throughout their medical training and practice. Conclusions: The elective QI curriculum was effective in guiding preclinical students to develop their QI knowledge base and skillset. Preclinical students value QI as an integral component of their medical training. Future directions involve evaluating the impact of this curriculum on clinical clerkship performance and across other academic institutions.
MeSH term(s)	Humans ; Prospective Studies ; Cohort Studies ; Quality Improvement ; Curriculum ; Students, Medical
Language	English
Publishing date	2023-01-26
Publishing country	England
Document type	Journal Article
ZDB-ID	2044473-4
ISSN	1472-6920 ; 1472-6920
ISSN (online)	1472-6920
ISSN	1472-6920
DOI	10.1186/s12909-023-04047-0
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Article ; Online: Core Data Elements for Pregnancy Pharmacovigilance Studies Using Primary Source Data Collection Methods: Recommendations from the IMI ConcePTION Project.

Richardson, Jonathan L / Moore, Alan / Bromley, Rebecca L / Stellfeld, Michael / Geissbühler, Yvonne / Bluett-Duncan, Matthew / Winterfeld, Ursula / Favre, Guillaume / Alexe, Amalia / Oliver, Alison M / van Rijt-Weetink, Yrea R J / Hodson, Kenneth K / Rezaallah, Bita / van Puijenbroek, Eugene P / Lewis, David J / Yates, Laura M

Drug safety

2023 Volume 46, Issue 5, Page(s) 479–491

Abstract: Introduction and objective: The risks and benefits of medication use in pregnancy are typically established through post-marketing observational studies. As there is currently no standardised or systematic approach to the post-marketing assessment of ... ...

Abstract	Introduction and objective: The risks and benefits of medication use in pregnancy are typically established through post-marketing observational studies. As there is currently no standardised or systematic approach to the post-marketing assessment of medication safety in pregnancy, data generated through pregnancy pharmacovigilance (PregPV) research can be heterogenous and difficult to interpret. The aim of this article is to describe the development of a reference framework of core data elements (CDEs) for collection in primary source PregPV studies that can be used to standardise data collection procedures and, thereby, improve data harmonisation and evidence synthesis capabilities. Methods: This CDE reference framework was developed within the Innovative Medicines Initiative (IMI) ConcePTION project by experts in pharmacovigilance, pharmacoepidemiology, medical statistics, risk-benefit communication, clinical teratology, reproductive toxicology, genetics, obstetrics, paediatrics, and child psychology. The framework was produced through a scoping review of data collection systems used by established PregPV datasets, followed by extensive discussion and debate around the value, definition, and derivation of each data item identified from these systems. Results: The finalised listing of CDEs comprises 98 individual data elements, arranged into 14 tables of related fields. These data elements are openly available on the European Network of Teratology Information Services (ENTIS) website ( http://www.entis-org.eu/cde ). Discussion: With this set of recommendations, we aim to standardise PregPV primary source data collection processes to improve the speed at which high-quality evidence-based statements can be provided about the safety of medication use in pregnancy.
MeSH term(s)	Pregnancy ; Female ; Humans ; Child ; Pharmacovigilance ; Data Collection ; Biomedical Research
Language	English
Publishing date	2023-03-28
Publishing country	New Zealand
Document type	Review ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1018059-x
ISSN	1179-1942 ; 0114-5916
ISSN (online)	1179-1942
ISSN	0114-5916
DOI	10.1007/s40264-023-01291-7
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Article ; Online: Neurodevelopment of babies born to mothers with epilepsy: A prospective observational cohort study.

Bromley, Rebecca L / Bullen, Philip / Campbell, Ellen / Craig, John / Ingham, Amy / Irwin, Beth / Jackson, Cerain / Kelly, Teresa / Morrow, James / Rushton, Sarah / García-Fiñana, Marta / Hughes, David M / Winterbottom, Janine / Wood, Amanda / Yates, Laura M / Clayton-Smith, Jill

Epilepsia

2023 Volume 64, Issue 9, Page(s) 2454–2471

Abstract: Objective: Despite widespread monotherapy use of lamotrigine or levetiracetam during pregnancy, prospectively collected, blinded child development data are still limited. The NaME (Neurodevelopment of Babies Born to Mothers With Epilepsy) Study ... ...

Abstract	Objective: Despite widespread monotherapy use of lamotrigine or levetiracetam during pregnancy, prospectively collected, blinded child development data are still limited. The NaME (Neurodevelopment of Babies Born to Mothers With Epilepsy) Study prospectively recruited a new cohort of women with epilepsy and their offspring for longitudinal follow-up. Methods: Pregnant women of <21 weeks gestation (n = 401) were recruited from 21 hospitals in the UK. Data collection occurred during pregnancy (recruitment, trimester 3) and at 12 and 24 months of age. The primary outcome was blinded assessment of infant cognitive, language, and motor development on the Bayley Scales of Infant and Toddler Development (3rd edition) at 24 months of age with supplementary parent reporting on the Vinelands Adaptive Behavior Scales (2nd edition). Results: There were 394 live births, with 277 children (70%) completing the Bayley assessment at 24 months. There was no evidence of an association of prenatal exposure to monotherapy lamotrigine (-.74, SE = 2.9, 95% confidence interval [CI] = -6.5 to 5.0, p = .80) or levetiracetam (-1.57, SE = 3.1, 95% CI = -4.6 to 7.7, p = .62) with poorer infant cognition, following adjustment for other maternal and child factors in comparison to nonexposed children. Similar results were observed for language and motor scores. There was no evidence of an association between increasing doses of either lamotrigine or levetiracetam. Nor was there evidence that higher dose folic acid supplementation (≥5 mg/day) or convulsive seizure exposure was associated with child development scores. Continued infant exposure to antiseizure medications through breast milk was not associated with poorer outcomes, but the number of women breastfeeding beyond 3 months was low. Significance: These data are reassuring for infant development following in utero exposure to monotherapy lamotrigine or levetiracetam, but child development is dynamic, and future follow-up is required to rule out later emerging effects.
MeSH term(s)	Infant ; Humans ; Female ; Pregnancy ; Lamotrigine/therapeutic use ; Levetiracetam/therapeutic use ; Levetiracetam/pharmacology ; Mothers ; Prospective Studies ; Epilepsy/drug therapy ; Anticonvulsants/adverse effects ; Child Development ; Prenatal Exposure Delayed Effects/chemically induced
Chemical Substances	Lamotrigine (U3H27498KS) ; Levetiracetam (44YRR34555) ; Anticonvulsants
Language	English
Publishing date	2023-07-16
Publishing country	United States
Document type	Observational Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	216382-2
ISSN	1528-1167 ; 0013-9580
ISSN (online)	1528-1167
ISSN	0013-9580
DOI	10.1111/epi.17709
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Article ; Online: School-aged children who were exposed to sodium valproate in utero have impaired language scores when compared with a population mean score.

Baker, Gus A / Bromley, Rebecca L

Evidence-based medicine

2011 Volume 16, Issue 6, Page(s) 178–179

Language	English
Publishing date	2011-12
Publishing country	England
Document type	Comment ; Journal Article
ZDB-ID	1324346-9
ISSN	1473-6810 ; 1356-5524
ISSN (online)	1473-6810
ISSN	1356-5524
DOI	10.1136/ebmed-2011-000025
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Article ; Online: Intellectual functioning in clinically confirmed fetal valproate syndrome.

Bromley, Rebecca L / Baker, Gus A / Clayton-Smith, Jill / Wood, Amanda G

Neurotoxicology and teratology

2018 Volume 71, Page(s) 16–21

Abstract: Background: An increased risk of impaired intelligence (IQ) has been documented in valproate-exposed children, but investigations have not previously focused on those with a clinical diagnosis of Fetal Valproate Syndrome (FVS).: Methods: This cross ... ...

Abstract	Background: An increased risk of impaired intelligence (IQ) has been documented in valproate-exposed children, but investigations have not previously focused on those with a clinical diagnosis of Fetal Valproate Syndrome (FVS). Methods: This cross sectional observational study recruited individuals with a diagnosis of FVS and completed standardized assessments of intellectual abilities making comparisons to a normative comparison group. Both mean difference (MD) and prevalence of scores below the lower average range were analyzed. Results: The mean full-scale IQ in 31 individuals with FVS (mean age 14.97; range 6-27 years) was 19 points lower (19.55, 95% CI -24.94 to 14.15), and IQ scores <70 were present in 26%. The mean differences for verbal comprehension (21.07, 95% CI -25.84 to -16.29), working memory (19.77, 95% CI -25.00 to -14.55) and processing speed (16.87, 95% CI -22.24 to -11.50) performances were poorer than expected with the mean differences over one standard deviation from the comparison group. Sixty one percent of cases demonstrated disproportionately lower verbal comprehension ability. There were no significant group differences for IQ in high vs. moderate dose valproate or mono vs. polytherapy. There were no differences in IQ between those with and those without a major congenital malformation. The requirement for educational intervention was high at 74%. Conclusion: Intellectual difficulties are a central feature of FVS and are more severe in their presentation in individuals with a diagnosis of valproate embryopathy. Individuals with FVS who present with the characteristic facial presentation should be considered at high risk of cognitive difficulties regardless of the dose of valproate exposure or the presence of a major congenital malformation.
MeSH term(s)	Abnormalities, Drug-Induced ; Adolescent ; Adult ; Child ; Comprehension/drug effects ; Cross-Sectional Studies ; Dose-Response Relationship, Drug ; Female ; Humans ; Intellectual Disability/chemically induced ; Intellectual Disability/psychology ; Male ; Memory, Short-Term/drug effects ; Valproic Acid/adverse effects ; Wechsler Scales ; Young Adult
Chemical Substances	Valproic Acid (614OI1Z5WI)
Language	English
Publishing date	2018-11-16
Publishing country	United States
Document type	Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	639165-5
ISSN	1872-9738 ; 0892-0362
ISSN (online)	1872-9738
ISSN	0892-0362
DOI	10.1016/j.ntt.2018.11.003
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