Antiseizure medication use during pregnancy and children’s neurodevelopmental outcomes
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 cr...
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Nature Portfolio
2024-11-01
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| Series: | Nature Communications |
| Online Access: | https://doi.org/10.1038/s41467-024-53813-1 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Paul Madley-Dowd |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-cfdbe3991d61448aadab3fa615898f90 |
| institution | Kabale University |
| issn | 2041-1723 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Nature Communications |
| spelling | doaj-art-cfdbe3991d61448aadab3fa615898f902024-11-17T12:35:53ZengNature PortfolioNature Communications2041-17232024-11-0115111110.1038/s41467-024-53813-1Antiseizure medication use during pregnancy and children’s neurodevelopmental outcomesPaul Madley-Dowd0Viktor H. Ahlqvist1Harriet Forbes2Jessica E. Rast3Florence Z. Martin4Caichen Zhong5Ciarrah-Jane S. Barry6Daniel Berglind7Michael Lundberg8Kristen Lyall9Craig J. Newschaffer10Torbjörn Tomson11Neil M. Davies12Cecilia Magnusson13Dheeraj Rai14Brian K. Lee15Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of BristolInstitute of Environmental Medicine, Karolinska InstitutetCentre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of BristolA.J. Drexel Autism Institute, Drexel UniversityCentre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of BristolA.J. Drexel Autism Institute, Drexel UniversityCentre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of BristolDepartment of Global Public Health, Karolinska InstitutetDepartment of Global Public Health, Karolinska InstitutetDepartment of Epidemiology and Biostatistics, Drexel University Dornsife School of Public HealthCollege of Health and Human Development, The Pennsylvania State UniversityDepartment of Clinical Neuroscience, Karolinska InstituteK.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and TechnologyDepartment of Global Public Health, Karolinska InstitutetCentre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of BristolA.J. Drexel Autism Institute, Drexel UniversityAbstract 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.https://doi.org/10.1038/s41467-024-53813-1 |
| spellingShingle | 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 Antiseizure medication use during pregnancy and children’s neurodevelopmental outcomes Nature Communications |
| title | Antiseizure medication use during pregnancy and children’s neurodevelopmental outcomes |
| title_full | Antiseizure medication use during pregnancy and children’s neurodevelopmental outcomes |
| title_fullStr | Antiseizure medication use during pregnancy and children’s neurodevelopmental outcomes |
| title_full_unstemmed | Antiseizure medication use during pregnancy and children’s neurodevelopmental outcomes |
| title_short | Antiseizure medication use during pregnancy and children’s neurodevelopmental outcomes |
| title_sort | antiseizure medication use during pregnancy and children s neurodevelopmental outcomes |
| url | https://doi.org/10.1038/s41467-024-53813-1 |
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