The prevalence of neurodevelopmental disorders in children prenatally exposed to antiepileptic drugs

Rebecca Louise Bromley, George E. Mawer, Maria Briggs, Christopher Cheyne, Jill Clayton-Smith, Marta García-Fiñana, Rachel Kneen, Sam B. Lucas, Rebekah Shallcross, Gus A. Baker, Pete Dixon (Collaborator), Alan Fryer (Collaborator), Alison Gummery (Collaborator), Loretta Kerr (Collaborator)

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    The aim of this study was to compare the prevalence of diagnosed neurodevelopmental disorders in children exposed, in utero, to different antiepileptic drug treatments. A prospective cohort of women with epilepsy and a control group of women without epilepsy were recruited from antenatal clinics. The children of this cohort were followed longitudinally until 6 years of age (n=415). Diagnosis of a neurodevelopmental disorder was made independently of the research team. Multiple logistic regression analysis revealed an increase in risk of neurodevelopmental disorders in children exposed to monotherapy sodium valproate (VPA) (6/50, 12.0%; aOR 6.05, 95%CI 1.65 to 24.53, p=0.007) and in those exposed to polytherapy with sodium VPA (3/20, 15.0%; aOR 9.97, 95% CI 1.82 to 49.40, p=0.005) compared with control children (4/214; 1.87%). Autistic spectrum disorder was the most frequent diagnosis. No significant increase was found among children exposed to carbamazepine (1/50) or lamotrigine (2/30). An accumulation of evidence demonstrates that the risks associated with prenatal sodium VPA exposure include an increased prevalence of neurodevelopmental disorders. Whether such disorders are discrete or represent the severe end of a continuum of altered neurodevelopmental functioning requires further investigation. Replication and extension of this research is required to investigate the mechanism(s) underpinning the relationship. Finally, the increased likelihood of neurodevelopmental disorders should be communicated to women for whom sodium VPA is a treatment option.
    Original languageEnglish
    Pages (from-to)637-643
    Number of pages6
    JournalJournal of Neurology, Neurosurgery and Psychiatry
    Issue number6
    Publication statusPublished - Jun 2013


    • Epilepsy
    • Neuropsychology
    • Neurotoxicology
    • Obstetrics
    • Paediatric


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