Investigating Antiseizure Medication Use During Pregnancy and Autism Risk
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Reviewed by Dat Tien Nguyen, B.A, ScM.
Translated by Nhi Phuong Quynh Le, B.A |
Posted on April 17th, 2024
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During pregnancy, the administration of medication can significantly influence fetal development. Expectant mothers with epilepsy often require antiseizure medication throughout their pregnancy to manage their condition. Numerous studies have indicated that certain medications like topiramate, valproate, and lamotrigine may have teratogenic effects, potentially resulting in adverse neurodevelopmental outcomes. Consequently, the United States National Institute of Mental Health funded a comprehensive study to investigate the correlation between maternal use of antiseizure medication and the risk of autism spectrum disorder in their children.
From two independent health insurance databases, a retrospective cohort study was conducted involving over 4 million pregnant women who delivered children without chromosomal abnormalities or major congenital malformations. Among this large cohort, a smaller subset consisted of women diagnosed with epilepsy, and an even smaller proportion of them were prescribed antiseizure medication during pregnancy, specifically valproate, topiramate, or lamotrigine, filled after the 19th week of gestation. Comparatively, there was a group of pregnant women with epilepsy who discontinued treatment 90 days prior to their last menstrual period. The study revealed a significantly higher rate of autism among pregnant women with epilepsy who did not receive antiseizure medication (4.2%) compared to the general population (1.9%). Within the epilepsy subgroup, in utero exposure to valproate was associated with a 10.5% risk of autism, significantly higher than the control rate of 4.2%. Exposure to topiramate was also linked to a 6.2% higher risk of autism. Notably, lamotrigine, among the three antiseizure medications studied, showed no association with autism.
From two independent health insurance databases, a retrospective cohort study was conducted involving over 4 million pregnant women who delivered children without chromosomal abnormalities or major congenital malformations. Among this large cohort, a smaller subset consisted of women diagnosed with epilepsy, and an even smaller proportion of them were prescribed antiseizure medication during pregnancy, specifically valproate, topiramate, or lamotrigine, filled after the 19th week of gestation. Comparatively, there was a group of pregnant women with epilepsy who discontinued treatment 90 days prior to their last menstrual period. The study revealed a significantly higher rate of autism among pregnant women with epilepsy who did not receive antiseizure medication (4.2%) compared to the general population (1.9%). Within the epilepsy subgroup, in utero exposure to valproate was associated with a 10.5% risk of autism, significantly higher than the control rate of 4.2%. Exposure to topiramate was also linked to a 6.2% higher risk of autism. Notably, lamotrigine, among the three antiseizure medications studied, showed no association with autism.