Antiseizure drugs during pregnancy may increase risk of neurodevelopmental diagnoses in children
Children whose mothers have taken antiseizure drugs during pregnancy are more likely than others to receive a neurodevelopmental diagnosis, a comprehensive new study shows. However, the researchers emphasise that the absolute risk is low.
Antiseizure drugs are used to treat epilepsy and to stabilise mood in certain psychiatric conditions, and some of these drugs, such as valproate, are known to affect the foetus if used during pregnancy.
Recently researchers from the University of Karolinska, the University of Bristol, and Aarhus University conducted a study where they examined data from over three million children in the UK and Sweden, 17,495 of whom had been exposed to antiseizure drugs during pregnancy.
The study, recently published in Nature Communications, showed that children exposed to valproate were much more likely to be diagnosed with autism, intellectual disability or ADHD compared to children not exposed to antiseizure drugs. Children exposed to topiramate had a 2.5-fold increased risk of intellectual disability, while those exposed to carbamazepine had a 25 per cent increased risk of being diagnosed with autism and a 30 per cent increased risk of intellectual disability.
However, the researchers found no evidence that taking the antiseizure drug lamotrigine during pregnancy increases the risk of neurodevelopmental diagnoses in the child.
“While the overall risk is still very low, our study shows that some drugs are linked to a markedly higher risk of children being diagnosed with neurodevelopmental conditions. This is something medical experts should be mindful of when prescribing antiseizure drugs to patients that are or may become pregnant, “explains Postdoc Viktor H. Ahlqvist from the Department of Biomedicine at Aarhus University, who is shared first author of the study.
The researchers emphasise that the absolute risk of the child receiving a neurodevelopmental diagnosis is low and that there may also be risks associated with not taking antiseizure medication during pregnancy.
“If you’re pregnant or trying to become pregnant, and taking one of these medications, it may be worth talking with your physician to make sure you’re taking the best medicine for your needs, while minimising risk to future children,” says Viktor H. Ahlqvist.
The results support previous findings from smaller studies that found links between antiseizure drugs during pregnancy and the risk of neurodevelopmental diagnoses in the child. One difference is that the new study found no statistically significant association between topiramate or levetiracetam and ADHD in the child.
The researchers’ behind the study hopes to elaborate on the recent findings with further studies on a global scale, explains Viktor H. Ahlqvist.
“We still don’t have a complete understanding of the safety of these medications, and because they are essential for pregnant individuals who need them, ongoing research remains crucial.”
This news article is based on a press release from Drexel University.
Behind the research results:
- Study type: Prospective cohort within UK and Swedish electronic health registries.
- Collaborators: Karolinska Institutet, University of Bristol, Drexel University, and others.
- External funding: National Institutes of Health, the Erik and Edith Fernström Foundation for Medical Research, Karolinska Institutet and the Swedish Society for Medical Research
- Information on any impartiality issues: Some of the authors have received honoraria from companies outside the current work. See the scientific article for more information on potential conflicts of interest.
- Direct link to the abstract or the scientific article: https://www.nature.com/articles/s41467-024-53813-1
(“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, Brian K. Lee, Nature Communications, online 15 November 2024, doi: 10.1038/s41467-024-53813-1.)
Contact
Postdoc, Viktor H. Ahlqvist
Department of Biomedicine, Health, Aarhus University
Phone: (+46) 704045347
E-mail: viktor.ahlqvist@biomed.au.dk