In Utero Exposure to Certain Antiepileptics Tied to Neurodevelopmental Diagnoses

MONDAY, Nov. 25, 2024 (HealthDay News) — Exposure to certain antiseizure medications (ASMs) in utero is associated with an increased likelihood of neurodevelopmental diagnoses, according to a study published online Nov. 15 in Nature Communications.

Paul Madley-Dowd, Ph.D., from the University of Bristol in the United Kingdom, and colleagues created a cohort of 3,182,773 children, of whom 17,495 were exposed to ASMs in pregnancy, using routinely collected primary care data from the United Kingdom and nationwide Swedish registers to examine the long-term safety of ASMs.

The researchers found that compared with children not exposed to ASMs, those exposed to valproate were more likely to receive a diagnosis of autism, intellectual disability, and attention-deficit/hyperactivity disorder. Children exposed to topiramate were 2.5 times more likely to be diagnosed with intellectual disability, while those exposed to carbamazepine were 1.25 and 1.30 times more likely to be diagnosed with autism and intellectual disability, respectively. Little evidence was found to indicate that exposure to lamotrigine in pregnancy was associated with increased odds of neurodevelopmental diagnoses.

“The findings of this large-scale study suggest that topiramate, carbamazepine, and valproate, but not lamotrigine, use during pregnancy are associated with higher risks of neurodevelopmental conditions in exposed children,” the authors write. “These observational associations translate to tangible absolute risk increases (ranging from 0.3 to 2.1 extra cases by age 12 per 100 children exposed in utero).”

One author disclosed ties to the pharmaceutical industry; a second author disclosed ties to law firms and AlphaSights.

Abstract/Full Text