Exposure to Valproate During Pregnancy May Have Effect on Offspring's School Performance

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Compared with unexposed children, carbamazepine, lamotrigine, phenobarbital, and oxcarbazepine exposure were not associated with poor school performance.
Compared with unexposed children, carbamazepine, lamotrigine, phenobarbital, and oxcarbazepine exposure were not associated with poor school performance.

HealthDay News — School performance is significantly lower for children with prenatal exposure to valproate, according to a study published online in JAMA Neurology.

Lars Skou Elkjaer, MD, from Aarhus University in Denmark, and colleagues conducted a population-based cohort study to examine the correlation between long-term school performance and prenatal exposure to valproate and other antiepileptic drugs (AEDs). Data were included for 479,027 children born alive in Denmark between 1997 and 2006 who participated in national academic tests.

The researchers found that children exposed to valproate scored worse on the sixth-grade Danish tests (adjusted difference, −0.27 standard deviation [SD]) and sixth-grade mathematics tests (adjusted difference, − 0.33 SD) compared with unexposed and lamotrigine-exposed children (adjusted difference, −0.33 SD). Clonazepam-exposed children scored worse in the sixth-grade Danish tests (adjusted difference, −0.07 SD). Compared with unexposed children, carbamazepine, lamotrigine, phenobarbital, and oxcarbazepine exposure were not associated with poor school performance.

"Maternal use of valproate was associated with a significant decrease in school performance in offspring compared with children unexposed to AEDs and children exposed to lamotrigine," the authors write. "Findings of this study further caution against the use of valproate among women of childbearing potential."

One author disclosed financial ties to the pharmaceutical industry.

Reference

Elkjaer LS, Bech BH, Sun Y, Laursen TM, Christensen J. Association between prenatal valproate exposure and performance on standardized language and mathematics tests in school-aged children [published online February 19, 2018]. JAMA Neurol. doi:10.1001/jamaneurol.2017.5035



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