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Antiseizure medication use during pregnancy and children’s neurodevelopmental outcomes

Author

Listed:
  • Paul Madley-Dowd

    (University of Bristol
    Medical Research Council Integrative Epidemiology Unit at the University of Bristol
    University of Bristol)

  • Viktor H. Ahlqvist

    (Karolinska Institutet
    Aarhus University)

  • Harriet Forbes

    (University of Bristol
    London School of Hygiene and Tropical Medicine)

  • Jessica E. Rast

    (Drexel University
    Drexel University Dornsife School of Public Health)

  • Florence Z. Martin

    (University of Bristol
    Medical Research Council Integrative Epidemiology Unit at the University of Bristol)

  • Caichen Zhong

    (Drexel University)

  • Ciarrah-Jane S. Barry

    (University of Bristol
    Medical Research Council Integrative Epidemiology Unit at the University of Bristol)

  • Daniel Berglind

    (Karolinska Institutet
    Region Stockholm)

  • Michael Lundberg

    (Karolinska Institutet)

  • Kristen Lyall

    (Drexel University Dornsife School of Public Health)

  • Craig J. Newschaffer

    (The Pennsylvania State University)

  • Torbjörn Tomson

    (Karolinska Institute)

  • Neil M. Davies

    (Norwegian University of Science and Technology
    University College London
    University College London)

  • Cecilia Magnusson

    (Karolinska Institutet
    Region Stockholm)

  • Dheeraj Rai

    (University of Bristol
    Medical Research Council Integrative Epidemiology Unit at the University of Bristol
    University of Bristol
    Avon and Wiltshire Partnership NHS Mental Health Trust)

  • Brian K. Lee

    (Drexel University
    Drexel University Dornsife School of Public Health
    Karolinska Institutet)

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.

Suggested Citation

  • Paul Madley-Dowd & Viktor H. Ahlqvist & Harriet Forbes & Jessica E. Rast & Florence Z. Martin & Caichen Zhong & Ciarrah-Jane S. Barry & Daniel Berglind & Michael Lundberg & Kristen Lyall & Craig J. Ne, 2024. "Antiseizure medication use during pregnancy and children’s neurodevelopmental outcomes," Nature Communications, Nature, vol. 15(1), pages 1-11, December.
  • Handle: RePEc:nat:natcom:v:15:y:2024:i:1:d:10.1038_s41467-024-53813-1
    DOI: 10.1038/s41467-024-53813-1
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    References listed on IDEAS

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    1. Patrick Royston & Paul C. Lambert, 2011. "Flexible Parametric Survival Analysis Using Stata: Beyond the Cox Model," Stata Press books, StataCorp LLC, number fpsaus, August.
    2. R. A. Charlton & A. McGrogan & J. Snowball & L. M. Yates & A. Wood & J. Clayton-Smith & W. H. Smithson & J. L. Richardson & N. McHugh & S. H. L. Thomas & G. A. Baker & R. Bromley, 2017. "Sensitivity of the UK Clinical Practice Research Datalink to Detect Neurodevelopmental Effects of Medicine Exposure in Utero: Comparative Analysis of an Antiepileptic Drug-Exposed Cohort," Drug Safety, Springer, vol. 40(5), pages 387-397, May.
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