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Prenatal exposure to sodium valproate linked to greater autism spectrum disorder risk, according to early results
Wednesday, December 10 2008 | Comments
What's This?
Sodium valproate taken during pregnancy may be associated with increased risk for autism spectrum disorders (ASD) in offspring, preliminary data reveal.The Liverpool and Manchester Neurodevelopment group is assessing the effects of antiepilepsy drugs (AED) in utero through an ongoing prospective study. Thus far, they have collected data on 632 live births--296 among women with epilepsy and 336 among women without epilepsy. In total, 249 of the babies of women with epilepsy were exposed to AED monotherapy or polytherapy at the beginning of gestation. Medical and neuropsychological assessment are being conducted among the children until age 6 years.
Nine children overall have received a diagnosis of ASD, and an additional child has ASD features, yielding a total incidence of 1.6%.
Of these 10 children, 7 were exposed to AEDs (2.8% of the 249 exposed babies). Four children were exposed to sodium valproate (6.3% of the 64 exposed to the drug), 1 to sodium valproate in combination with lamotrigine (2.0% of the 51 exposed to the drug combination), 1 to phenytoin (11.0% of the 9 exposed to the drug), and 1 to lamotrigine (2.0% of the 44 exposed to the drug). The 3 remaining children with ASD were born to control mothers, representing an ASD rate of 0.9%. No child had a family history of autism or other pervasive developmental disorders according to parental interviews.
The study authors noted that the 6.3% rate of ASD or its features in children exposed to sodium valproate is 7 times higher than the rate of the control group (0.9%) and greater than the 0.6% reported incidence among children in the general population.
They emphasized that these results were preliminary and there were relatively small samples sizes for each group, so additional prospective studies would be necessary.
"Women who are prescribed sodium valproate during pregnancy should be counseled preconceptionally and informed specifically of this potential risk," the investigators concluded. (Bromley RL, et al. Neurology 2008;71:1923-1924.)
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