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Maternal Use of Valproic Acid Linked to ASD, ADHD in Offspring

THURSDAY, Oct. 29, 2020 -- Maternal use of valproic acid, but not lamotrigine, is associated with an increased risk for autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) among children, according to a study published online Oct. 28 in Neurology.

Kelsey K. Wiggs, from Indiana University in Bloomington, and colleagues used Swedish-registry data to examine the risks for ASD and ADHD in 14,614 children born from 1996 to 2011 to women with epilepsy. Maternal-reported first-trimester use of any antiseizure medications and the three most commonly reported individual drugs (valproic acid, lamotrigine, and carbamazepine) were examined.

The researchers found that after adjustment for confounding, valproic acid use was associated with ASD and ADHD (hazard ratios, 2.30 [95 percent confidence interval, 1.53 to 3.47] and 1.74 [95 percent confidence interval, 1.28 to 2.38], respectively). A small, non-statistically significant association with ASD and ADHD was seen for reported use of carbamazepine (hazard ratios, 1.25 [95 percent confidence interval, 0.88 to 1.79] and 1.18 [95 percent confidence interval, 0.91 to 1.52], respectively), but all of the associations with lamotrigine were explained by confounding (hazard ratio for ASD, 0.86 [95 percent confidence interval, 0.67 to 1.53]; hazard ratio for ADHD, 1.01 [95 percent confidence interval, 0.67 to 1.53]).

"Our findings suggest that women who use antiseizure medications, particularly valproic acid, should weigh potential harm to the fetus, as well as ongoing seizure management, in their decision-making with their doctors if they are considering becoming pregnant," a coauthor said in a statement.

One author disclosed financial ties to the pharmaceutical industry.

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Posted: October 2020

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