Prenatal exposure to antiepileptic drug valproic acid

Takeaway

  • Prenatal exposure to the antiepileptic drug (AED) valproic acid (VPA) negates the usual predominance of males in the incidence of autism spectrum disorder (ASD), furthering the idea of VPA as a “behavioral teratogen”. There was no impact found on attention-deficit hyperactivity disorder (ADHD).

Why this matters

  • Pregnancy is a challenging issue for women with epilepsy, due to the potentially harmful effects of AEDs on the unborn fetus. Prenatal exposure to the commonly used AED VPA confers a 10% risk of major congenital malformations and a 48% increased risk of ADHD.

  • In the general population, males are up to 4 times more likely to have ASD than females, a relationship which has also been applied to ADHD.

  • The sex-specific effects of VPA in neurodevelopment and the relationship with ASD and ADHD are yet to be elucidated.