Preschool behavioral problems in children prenatally exposed to antiepileptic drugs — A follow-up study

• AED-exposed children have the most abnormal SDQ scores except for emotional symptoms.
• A fivefold increase in OR of abnormal total SDQ scores for AED-exposed children
• AED-exposed children have an increased OR of abnormal conduct problem scores.

We studied the association between maternal epilepsy, antiepileptic drug (AED) treatment, and behavioral problems in preschool children.In the Danish National Birth Cohort, we identified 4- to 5-year-old children whose mothers had epilepsy and received AED treatment (n = 133) or not (n = 304) during pregnancy and compared them with randomly selected children whose mothers did not have epilepsy (n = 1193). The children's behavioral problems were assessed by the use of the Strengths and Difficulties Questionnaire (SDQ).Children prenatally exposed to AEDs more often had an abnormal total SDQ score as compared with children of women without epilepsy (odds ratio (OR) = 4.8 (95% CI: 1.9–12.1)) and as compared with children of women with epilepsy who were not treated with AEDs during their pregnancy (OR = 4.0 (95% CI: 1.3–12.8)).In conclusion, prenatal AED exposure may increase the risk of behavioral problems in preschool children even after adjustments for potential confounders and maternal epilepsy.