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Medications and More during pregnancy and breastfeeding

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Valproic Acid

Selected References:

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  • Aydin B, et al. 2015. Olanzapine and quetiapine use during breastfeeding: excretion into breast milk and safe breastfeeding strategy. J Clin Psychopharmacol 35(2):206-8.
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  • Blotière PO et al. Risk of early neurodevelopmental outcomes associated with prenatal exposure to the antiepileptic drugs most commonly used during pregnancy: a French nationwide population-based cohort study. BMJ Open. 2020 Jun 7;10(6):e034829. doi: 10.1136/bmjopen-2019-034829. PMID: 32513880; PMCID: PMC7282331.
  • Coban D, et al. 2010. Neonatal episodic hypoglycemia: a finding of valproic acid withdrawal. J Clin Res Pediatr Endocrinol 2(2):92-4.
  • Daugaard CA et al.Association of Prenatal Exposure to Valproate and Other Antiepileptic Drugs With Intellectual Disability and Delayed Childhood Milestones. JAMA Netw Open. 2020 Nov 2;3(11):e2025570. doi: 10.1001/jamanetworkopen.2020.25570. PMID: 33170264; PMCID: PMC7656282.
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  • Di Y et al. Maternal folic acid supplementation prevents autistic behaviors in a rat model induced by prenatal exposure to valproic acid. Food Funct. 2021 May 21;12(10):4544-4555. doi: 10.1039/d0fo02926b. Epub 2021 Apr 27. PMID: 33903876.
  • Diav-Citrin O, et al. 2009. Pregnancy outcome after in utero exposure to valproate: evidence of dose relationship in teratogenic effect. CNS Drugs 22(4):325-34.
  • Einarson A et al. 2009. Use and safety of antipsychotic drugs during pregnancy. J Psychiatr Pract 15: 183-92.
  • Harden CL, et al. 2009. Management issues for women with epilepsy – Focus on pregnancy (an evidence-based review): II. Teratogenesis and perinatal outcomes: Report of the Quality Standards Subcommittee and Therapeutics and Technology Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Epilepsia 50: 1237-46.
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  • Jentink J, et al. 2010. Valproic Acid Monotherapy in Pregnancy and Major Congenital Malformations. N Engl J Med 362:2185-93.
  • Kacirova I, Grundmann M, Brozmanova H. Valproic acid concentrations in nursing mothers, mature milk, and breastfed infants in monotherapy and combination therapy. Epilepsy Behav. 2019 Jun;95:112-116. doi: 10.1016/j.yebeh.2019.04.002. Epub 2019 Apr 28. PMID: 31035102.
  • Keni et al. Anti-epileptic drug and folic acid usage during pregnancy, seizure and malformation outcomes: Changes over two decades in the Kerala Registry of Epilepsy and Pregnancy. Epilepsy Res. 2020 Jan;159:106250. doi: 10.1016/j.eplepsyres.2019.106250. Epub 2019 Dec 9. PMID: 31855827.
  • Mawhinney E, et al. 2012. Valproate and the risk for congenital malformations: Is formulation and dosage regime important? Seizure 21(3):215-218.
  • Meador KJ, et al. 2012. Effects of fetal antiepileptic drug exposure: outcomes at age 4.5 years. Neurology 78(16):1207-14.
  • Meador KJ, et al. 2014. Breastfeeding in children of women taking antiepileptic drugs: Cognitive outcomes at age 6 years. JAMA Pediatr. 168:729-36.
  • Ornoy A. 2009. Valproic acid in pregnancy: how much are we endangering the embryo and fetus? ReprodToxicol 28: 1-10.
  • Shallcross R, et al. 2014. In utero exposure to levetiracetam vs valproate: development and language at 3 years of age. Neurology 82(3):213-21.
  • Smith, J et al. 2009. Sodium valproate and the fetus: a case study and review of the literature. Neonatal Netw 28: 363-7.
  • Sveberg L, et al. 2015. The impact of seizures on pregnancy and delivery. Seizure. 28:35-8.
  • Tomson T, et al. 2015. Valproate in the treatment of epilepsy in girls and women of childbearing potential. Epilepsia 56(7):1006-19.
  • Vajda FJ, et al. 2013. Dose dependence of fetal malformations associated with valproate. Neurology; 81(11):999-1003.
  • Vajda FJE, et al. 2019. Valproate-associated foetal malformations-Rates of occurrence, risks in attempted avoidance. Acta Neurol Scand 139(1):42-48.
  • Vajda FJE et al. Folic acid dose, valproate, and fetal malformations. Epilepsy Behav. 2021 Jan;114(Pt A):107569. doi: 10.1016/j.yebeh.2020.107569. Epub 2020 Dec 1. PMID: 33272896.
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  • Veroniki AA, et al. 2017. Comparative safety of anti-epileptic drugs during pregnancy: a systematic review and network meta-analysis of congenital malformations and prenatal outcomes. BMC medicine 15(1):95.
  • Weston J, et al. 2016. Monotherapy treatment of epilepsy in pregnancy: congenital malformation outcomes in the child. Cochrane Database Syst Rev 11:Cd010224.
  • Wiggs KK et al.Antiseizure medication use during pregnancy and risk of ASD and ADHD in children. Neurology. 2020 Dec 15;95(24):e3232-e3240. doi: 10.1212/WNL.0000000000010993. Epub 2020 Oct 28. PMID: 33115775; PMCID: PMC7836668.
  • Yerby MS, McCoy GB. 1999. Male infertility: possible association with valproate exposure. Epilepsia 40:520-1.
  • Yonkers KA et al. 2004. Management of bipolar disorders during pregnancy and the postpartum period. Am J Psych 161:608-20.