Valproate-associated foetal malformations—Rates of occurrence, risks in attempted avoidance

Abstract

Objectives: To gain insight into the main advantages and disadvantages that might result from valproate being unavailable for women who intend to become pregnant. Materials and Methods: Analysis of data from the Australian Pregnancy Register concerning pregnancies exposed to valproate (N = 501) and pregnancies where previous valproate intake had been ceased before pregnancy (N = 101). Results: The risk of foetal malformation associated with valproate exposure during pregnancy was dose-related, and there was a tendency for the more major malformations, including those often managed by therapeutic abortion, for example spina bifida, to occur at higher valproate doses. Had there been no exposur..