Antiseizure medication use during pregnancy and children’s neurodevelopmental outcomes

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. Newschaffer, Torbjörn Tomson, Neil M. Davies, Cecilia Magnusson, Dheeraj Rai and Brian K. Lee
Additional contact information
Paul Madley-Dowd: University of Bristol
Viktor H. Ahlqvist: Karolinska Institutet
Harriet Forbes: University of Bristol
Jessica E. Rast: Drexel University
Florence Z. Martin: University of Bristol
Caichen Zhong: Drexel University
Ciarrah-Jane S. Barry: University of Bristol
Daniel Berglind: Karolinska Institutet
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
Cecilia Magnusson: Karolinska Institutet
Dheeraj Rai: University of Bristol
Brian K. Lee: Drexel University

Nature Communications, 2024, vol. 15, issue 1, 1-11

Abstract: 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.

Date: 2024
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DOI: 10.1038/s41467-024-53813-1

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