THURSDAY, March 19, 2026 (HealthDay News) -- Prenatal valproate exposure is associated with increased neurodevelopmental risks among offspring, according to a study published online March 11 in The BMJ.
In a study using health care use data from 2000 to 2021, Loreen Straub, M.D., from Brigham and Women's Hospital and Harvard Medical School in Boston, and colleagues examined whether prenatal exposure to specific antiseizure drugs increases the risk for neurodevelopmental disorders in children.
A total of 8,887 children who were unexposed prenatally were included in the cohort; exposed pregnancies ranged from 219 to 5,261 for lacosamide and levetiracetam, respectively. The researchers observed associations with several outcomes for valproate and zonisamide (adjusted hazard ratio range, 1.26 to 4.50), while no associations with an increased risk for any outcome were seen for levetiracetam and phenytoin. A twofold to fourfold increase in risk for intellectual disability was seen in association with several drugs; due to the small number of children with this disorder, the estimates were imprecise. Across most outcomes, no meaningful associations were seen for topiramate and lamotrigine, but a potential signal was seen for intellectual disability (both drugs) and learning difficulty (topiramate only; hazard ratio, 1.23 based on small numbers). A modest increase in risk for attention-deficit/hyperactivity disorder and behavioral disorders was seen in association with carbamazepine and oxcarbazepine (hazard ratio range, 1.23 to 1.40).
"Our findings raise potential concerns for zonisamide, which was associated with several neurodevelopmental disorders in the main analysis," the authors write. "However, these estimates are based on small numbers and should be interpreted with caution."
Several authors disclosed ties to the pharmaceutical industry.