10.51% of Infants Exposed to Valproate During Pregnancy Later Developed Autism
A comprehensive study involving 4 million American pregnant women and their children investigated the occurrence of autism spectrum disorder (ASD) associated with prenatal exposure to topiramate, valproate, or lamotrigine, commonly prescribed antiseizure medications. The study found that by age 8, 1.89% of children not exposed to any antiseizure medication were diagnosed with ASD. In comparison, the rate increased to 4.21% for children born to mothers with epilepsy but no prenatal antiseizure medication exposure. Among 8-year-olds born to mothers with epilepsy who used antiseizure medication during pregnancy, the rates of ASD were 6.15% with topiramate exposure, 10.51% with valproate exposure, and 4.08% with lamotrigine exposure. While children exposed to topiramate during the second half of pregnancy showed a higher incidence of ASD compared to the general population, there was no significant difference relative to other children born to women with epilepsy. After the authors adjusted the research for various factors, topiramate exposure did not significantly increase ASD risk, unlike valproate exposure, which was significantly associated with an increased risk. The authors believe their study provides reassurance regarding the ASD risk linked to fetal topiramate exposure but highlights the necessity for further research on the neurodevelopmental risks associated with antiseizure medications. Interestingly, recent findings from a Danish cohort study involving over 38,000 children suggested that children of mothers with epilepsy who used valproate or other antiseizure medications during pregnancy had a heightened likelihood of developing epilepsy themselves, although causality remained uncertain.
