Is it true that using Valproate in pregnancy causing ASD of kids?

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Is it true that pregnant woman can't use Valproate? I had Valproate for epilepsy. What if I have seizure again during pregnancy?

2 Answers

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It's true that Valproate isn't recommended to women in pregnancy, since research has shown in-utero exposure of Valproate is associated with learning disabilities among offspring.

In 2013,Dr. Christensen and colleagues report the results of a population-based study of 655,615 children born in Denmark from 1996 to 2006. Among these children, 5437 were identified as having autism spectrum disorder, including 2067 with childhood autism. When examining the relationship of fetal valproate exposure to developmental outcome, increased risks of autism spectrum disorder (absolute risk, 4.42%; adjusted hazard ratio, 2.9 [95% CI, 1.7-4.9]) and childhood autism (absolute risk, 2.50%; adjusted hazard ratio, 5.2 [95% CI, 2.7-10.0]) were observed among the 508 children exposed to valproate. The authors concluded that maternal use of valproate during pregnancy was associated with significantly increased risks of autism spectrum disorder and childhood autism in the offspring.

Therefore, the American Academy of Neurology recommended avoidance of valproate during pregnancy whenever possible.

Lamotrigine should preferentially be considered over valproate if clinically feasible.
Yes, it's true. Rescent research showed that maternal use of valproate during pregnancy was associated with a significantly increased risk of autism spectrum disorder and childhood autism in the offspring. For women of childbearing potential who use antiepileptic medications, these findings must be balanced against the treatment benefits for women who require valproate for epilepsy control.
Seizures can also cause fetal malformations, the main reason is that the seizures cause hypoxia or damage to the fetus, especially the continuous seizures and seizures in the first 3 months of pregnancy have a greater impact on the fetus. Seizures and the use of anti-epileptic drugs will have many consequences for pregnant women and their fetuses. On some issues such as how pregnant women use anti-epileptic drugs, the pros and cons should be fully measured, and it is best to take some measures under the guidance of a doctor. Including the following measures:
•    Female patients with epilepsy have no seizures or very few seizures within 2 to 5 years before pregnancy. Multiple EEG tests are normal, and pregnancy can be considered after stopping the drug. If you need to use antiepileptic drugs to control the author during pregnancy, it is best to choose a single drug and a small dose according to the type of attack, and try to use the lowest and effective drug dose.
•    Try to avoid multi-drug combination treatment during pregnancy, especially avoid the combined application of phenobarbital, sodium valproate and carbamazepine. It is best to take the daily dose in 3-4 times or use slow-release tablets to avoid excessive drug concentration in the body as much as possible.
•    It is best to monitor the blood concentration during pregnancy, every 3 months.
Before and during the first 3 months of pregnancy, take 0.4-4 mg of folic acid daily to prevent fetal malformations.
•    Strengthen the health checkup during pregnancy, and perform ultrasound examination and alpha-fetoprotein measurement during the 15-20 weeks of pregnancy (3.5-4.5 months of pregnancy), and strive to detect problems as soon as possible to take necessary measures.