Rasalam AD et al. (2005) Characteristics of fetal anticonvulsant syndrome associated autistic disorder. Dev Med Child Neurol 47: 551–555

Rasalam and colleagues have found evidence to implicate prenatal exposure to anticonvulsant medication in various neurodevelopmental disorders, and as a risk factor for the development of autism spectrum disorder (ASD).

In this 20-year, population-based study, 626 children born to 389 mothers who had been exposed to anticonvulsant medication, were identified from Aberdeen Maternity Hospital (Scotland, UK) records. Of these, 150 mothers and 260 children participated in this study.

In structured interviews, 26 children were reported by their parents to have social or behavioral difficulties. Of these, 11 children were diagnosed with an autistic disorder, and one was diagnosed with Asperger syndrome. In the 260 children exposed to antiepileptic drugs, the prevalence of ASD was calculated to be 4.6%. Sodium valproate was the drug most likely to be associated with an ASD; 8.9% of children exposed to this drug were diagnosed with an autistic disorder or Asperger syndrome. Several of the children with social or behavioral difficulties, but no autism, showed signs of a communication disorder such as a delay in the acquisition of speech and language skills.

The authors note that clinicians and families involved in the use of antiepileptic drugs during pregnancy should be aware of the association between these drugs and ASDs. This association should be considered when selecting the treatment options that are best for the patient and their family.