Antiseizure medication use during pregnancy and children’s neurodevelopmental outcomes

The teratogenic potential of valproate in pregnancy is well established; however, evidence regarding the long-term safety of other antiseizure medications (ASMs) during pregnancy remains limited. Using routinely collected primary care data from the UK and nationwide Swedish registries to create a cohort of 3,182,773 children, of which 17,495 were exposed to ASMs in pregnancy, we show that those exposed to valproate were more likely to receive a diagnosis of autism, intellectual disability, and ADHD, when compared to children not exposed to ASMs. Additionally, children exposed to topiramate were 2.5 times more likely to be diagnosed with intellectual disability (95% CI: 1.23-4.98), and those exposed to carbamazepine were 1.25 times more likely to be diagnosed with autism (95% CI: 1.05-1.48) and 1.30 times more likely to be diagnosed with intellectual disability (95% CI: 1.01-1.69). There was little evidence that children exposed to lamotrigine in pregnancy were more likely to receive neurodevelopmental diagnoses. While further research is needed, these findings may support considering safer treatment alternatives well before conception when clinically appropriate.

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Publication Details

Journal
Nature Communications
Published
2024-11-15
DOI
https://doi.org/10.1038/s41467-024-53813-1
Citations
30
Primary Topic
Pharmacological Effects and Toxicity Studies
Type
article
Field-Weighted Citation Impact
33.28

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article

Antiseizure medication use during pregnancy and children’s neurodevelopmental outcomes

Caichen Zhong, Torbjörn Tomson, Dheeraj Rai, Craig J. Newschaffer et al.
30 citations
Nature Communications
Pharmacological Effects and Toxicity Studies
33.28
article

Antiseizure medication use during pregnancy and children’s neurodevelopmental outcomes

Caichen Zhong, Torbjörn Tomson, Dheeraj Rai, Craig J. Newschaffer, Florence Z. Martin, Daniel Berglind, Ciarrah-Jane Barry, Brian K. Lee, Paul Madley‐Dowd, Kristen Lyall, Neil M Davies, Cecilia Magnusson, Harriet Forbes, Viktor H. Ahlqvist, Jessica E. Rast, Michael Lundberg
article en
30 citations

Abstract

The teratogenic potential of valproate in pregnancy is well established; however, evidence regarding the long-term safety of other antiseizure medications (ASMs) during pregnancy remains limited. Using routinely collected primary care data from the UK and nationwide Swedish registries to create a cohort of 3,182,773 children, of which 17,495 were exposed to ASMs in pregnancy, we show that those exposed to valproate were more likely to receive a diagnosis of autism, intellectual disability, and ADHD, when compared to children not exposed to ASMs. Additionally, children exposed to topiramate were 2.5 times more likely to be diagnosed with intellectual disability (95% CI: 1.23-4.98), and those exposed to carbamazepine were 1.25 times more likely to be diagnosed with autism (95% CI: 1.05-1.48) and 1.30 times more likely to be diagnosed with intellectual disability (95% CI: 1.01-1.69). There was little evidence that children exposed to lamotrigine in pregnancy were more likely to receive neurodevelopmental diagnoses. While further research is needed, these findings may support considering safer treatment alternatives well before conception when clinically appropriate.

Nature CommunicationsVol. 15(1)
Pennsylvania State University (US), Avon and Wiltshire Mental Health Partnership NHS Trust (GB), Aarhus University (DK), Norwegian University of Science and Technology (NO), Bristol City Council (GB), At Bristol (GB), Karolinska Institutet (SE), University of Bristol (GB), London School of Hygiene & Tropical Medicine (GB), NIHR Bristol Biomedical Research Centre (GB), Centre for Palaeogenetics (SE), University College London (GB), Drexel University (US), Medical Research Council (GB)
National Institute for Health and Care Research, University of Bristol, Fondation pour la Recherche Médicale, Svenska Sällskapet för Medicinsk Forskning, Karolinska Institutet, Norges Forskningsråd, Erik och Edith Fernströms Stiftelse för Medicinsk Forskning, National Institutes of Health, Medical Research Council
Good health and well-being
Openalex Percentile: Top 0%
Pharmacological Effects and Toxicity Studies
33.28
DOIOpen Access PDFOpenAlex
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