Journal article
Antiseizure medication use during pregnancy and children's neurodevelopmental outcomes
Nature communications, v 15(1), 9640
15 Nov 2024
PMID: 39548057
Featured in Collection : UN Sustainable Development Goals @ Drexel
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.
Some antiseizure medications including valporate are associated with neurodevelopmental conditions in children exposed in utero but evidence is less clear for other drugs. Here the authors investigate associations between antiseizure medication use in pregnancy and neurodevelopmental conditions using electronic health record data from the UK and Sweden.
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Details
- Title
- Antiseizure medication use during pregnancy and children's neurodevelopmental outcomes
- Creators
- Paul Madley-Dowd - University of BristolViktor H. Ahlqvist - Karolinska InstitutetHarriet Forbes - University of BristolJessica E. Rast - Drexel UniversityFlorence Z. Martin - University of BristolCaichen Zhong - Drexel UniversityCiarrah-Jane S. Barry - University of BristolDaniel Berglind - Karolinska InstitutetMichael Lundberg - Karolinska InstitutetKristen Lyall - Drexel UniversityCraig J. Newschaffer - Pennsylvania State UniversityTorbjörn Tomson - Karolinska InstitutetNeil M. Davies - University College LondonCecilia Magnusson - Karolinska InstitutetDheeraj Rai - University of BristolBrian K. Lee - Karolinska Institutet
- Publication Details
- Nature communications, v 15(1), 9640
- Publisher
- Nature Publishing Group UK
- Number of pages
- 11
- Grant note
- The study was funded by the National Institutes of Health (1R01NS107607-01A1), Erik and Edith Fernström Foundation for Medical Research (2020-00321), Karolinska Institutet (2020-00160, 2020-01172) and the Swedish Society for Medical Research (RM21-0005). This study was also supported by the NIHR Biomedical Research Centre at the University of Bristol and University Hospitals Bristol and Weston NHS Foundation Trust. PMD, FZM, CJSB, and DR are members of the UK Medical Research Council (MRC) Integrative Epidemiology unit, which is funded by the MRC (MC_UU_00032/01, MC_UU_00032/02, MC_UU_00032/04 and MC_UU_00032/6) and the University of Bristol. NMD is supported by the Norwegian Research Council Grant number 295989.
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics; A.J. Drexel Autism Institute
- Web of Science ID
- WOS:001356232600018
- Scopus ID
- 2-s2.0-85209180219
- Other Identifier
- 991021961015504721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Clinical Neurology