Valproic Acid used during pregnancy may be linked to Autism

Pregnant women taking the drug valproate to treat epilepsy, may significantly increase their baby’s risk of developing autism, according to a new study published in the journal Neurology.

However, experts say the benefits of the drug and the high risk of seizures during pregnancy may outweigh the risk of autism.

The study followed more than 600 children from pregnancy to birth and into childhood from 2000 to 2006.

Half of the children were exposed to epilepsy drugs while in the womb and the other half was not.
Statistically speaking, those children exposed to valproate sodium were seven times more likely to develop autism later in life compared to the children not exposed to the drug.

Although the findings were strong, the study was relatively small -- nine of the 632 children developed autism.

Autism is a brain disorder that affects a person's ability to communicate, form relationships, and respond to the environment. Individuals can have mild, moderate or severe autism.

An estimated one out of every 150 U.S. children has autism, according to the U.S. Centers for Disease Control and Prevention.

The study raises questions for autism researchers and parents in the epilepsy community, says Dr. Michael Goldstein, vice president of the American Academy of Neurology.

Depacon, also known as valproate sodium and valproic acid, is an anticonvulsant indicated in the treatment of certain types of seizures related to epilepsy. Approved by the U.S. Food and Drug Administration in 1997, Depacon is made by Abbott Laboratories.

Antiseizure medications, especially valproic acid has been known to cause “teratogenic malformation,” visible birth defects in the limbs.

Treating Epilepsy While Pregnant

Doctors are aware that some antiseizure medications can cause abnormalities in the brain. According to Goldstein, pregnant women with epilepsy are often forced to choose between the lesser of the two risks.

“Generally, we try to avoid valproic acid in pregnant women,” said Goldstein. “But, for some women who have trouble controlling epilepsy, they may be better off taking the medication then having seizures. Consensus is that seizures are worse for the babies than the drug.”

Uncontrolled seizures can cause permanent damage to the brain and for pregnant women can be fatal for mother and child.

“When considering the fetus developing inside the mom, the main thing parents are concerned about is organogenesis – do the limbs form right, are there ten fingers and ten toes – all of those things which are completed by the end of the first trimester, said French, also a fellow of the American Academy of Neurology.

That means, according to French, women with epilepsy and their doctors are more worried about the medications taken at the beginning of the pregnancy and less about which are taken at the end.
“But the brain develops after the first three months and throughout the pregnancy in the womb,” she said. She believes research that links valproic acid with brain development problems, including autism, should change the way these drugs are prescribed.”

Women that have epilepsy should not be afraid to have children, but they should consult their neurologist before deciding to start a family.