Risk-benefit assessment of treatment of epileptic women of childbearing age with valproic acid

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Valproic acid (VPA) is a widely used anti-epileptic drug (AED) of demonstrated efficacy [1,2]. However, since the 1980s, numerous published studies have highlighted the association between intrauterine exposure to VPA and the risk of a major congenital malformation (MCM) and neurodevelopmental problems. The risk of MCMs has been estimated at around 11%, with it increasing to 25% for doses above 1450 mg/day [3]. In children with intrauterine exposure to VPA, there is also evidence of an 8-10 point reduction in intelligence quotient (IQ) [4,5] and a 6-15% increase in the risk of developing an autism spectrum disorder (ASD) [6,7].

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