Caution Advised for Valproate Use During Pregnancy Due to Autism Link

A new study has found an increased risk for autism associated with valproate use in pregnancy.¹

Published in JAMA, the population-based cohort study compared children born in Denmark between 1996 and 2006 exposed prenatally to valproate (N = 508) with those who were not exposed (N = 655,107). Based on their analyses, the researchers found an absolute risk of 4.42% of valproate use during pregnancy with autism spectrum disorder and an absolute risk of 2.50% for childhood autism.

The risk for autism spectrum disorder increased among those women who filled a valproate prescription in the first trimester. However, dose did not seem to impact risk, as risks for autism spectrum disorder and autism were similar among those children whose mothers used a high dose (> 750 mg/day) as compared with those children whose mother used a low valproate dose (≤ 750 mg/day).

Although the researchers were unable to completely discern the reason for the prescriptions, they found an increased risk from valproate use in mothers with and without an epilepsy diagnosis, “suggesting a biological effect of valproate.”

“It appears that it [valproate] is being prescribed for women of childbearing potential at a rate that does not fully consider the ratio of benefits to risks,” Kimford J. Meador, MD, professor of neurology, and David W. Loring, PhD, professor of neurology and pediatrics and director of neuropsychology in the neurology department, Emory University, Atlanta, wrote in an accompanying editorial.²  “This raises concern as to whether these women are receiving adequate information for informed consent based on a full understanding of the treatment risks and alternative therapies."

References:

References

1.

Christensen J, Grønborg T, Sørensen M, et al. Prenatal valproate exposure and risk of autism spectrum disorders and childhood autism. JAMA. 2013;309(16):1696-1703.

http://jama.jamanetwork.com/article.aspx?articleid=1681408

. Accessed April 24, 2013.

2.

Meador KJ, Loring DW. Risks of In Utero Exposure to Valproate. JAMA. 2013;309(16):1730-1731.

http://jama.jamanetwork.com/article.aspx?articleid=1681385

. Accessed April 24, 2013.