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Implications for practice and research
Anticonvulsant drugs increase the risk of poor neurodevelopmental outcome.
Women taking sodium valproate should be counselled about potential risks well in advance of pregnancy.
Further research is required to understand whether lower doses reduce the risk of autism to population levels.
Prospective longitudinal studies assessing all children are necessary to clarify the full extent of risk associated with prenatal medication exposures.
The clinical management of women with epilepsy during pregnancy is complicated by the potential teratogenicity of medications needed to control seizures. Past research about the relationship between prenatal exposure to antiepileptic drugs and major congenital malformations has improved understanding of the immediate effects for the child, with recent studies highlighting the long-term impact on cognitive development.1 ,2 …
Competing interests AW is a member of the Executive and Scientific Advisory Committee of the Australian Pregnancy Register for Women with Epilepsy and Allied Disorders. The Australian Pregnancy Register receives financial support for its operations from the pharmaceutical industry, including Sanofi-Aventis, UCB, Janssen, Novartis and Pfizer Inc, as well as past support from GlaxoSmithKline.