Nat Commun

Antiseizure medication use during pregnancy tied to neurodevelopmental risks in children

November 29, 2024

Study design: This large-scale cohort study utilized primary care data from the U.K. and Swedish national registries, encompassing 3,182,773 children, including 17,495 exposed to antiseizure medications (ASMs) during pregnancy. The study aimed to assess the long-term neurodevelopmental outcomes associated with in utero exposure to various ASMs.

Results: Children exposed to valproate in utero had higher rates of autism (4.85%), intellectual disability (2.36%), and ADHD (6.34%) compared with unexposed children. Topiramate exposure was linked to a 2.5-fold increase in intellectual disability, while carbamazepine exposure was associated with a 1.25-fold increase in autism and a 1.30-fold increase in intellectual disability. Lamotrigine exposure showed little evidence of increased neurodevelopmental diagnoses.

Impact on clinical practice: These findings underscore the importance of careful consideration when prescribing ASMs to pregnant women. The potential neurodevelopmental risks associated with valproate and other ASMs necessitate exploring safer alternatives and providing thorough counseling to patients regarding these risks. Further research is needed to confirm the associations and guide clinical decision-making.

Source:

Madley-Dowd P, et al. (2024, November 25). Nat Commun. Antiseizure medication use during pregnancy and children's neurodevelopmental outcomes. https://pubmed.ncbi.nlm.nih.gov/39548057/