ReviewBMC pregnancy and childbirth2018
Sodium valproate in pregnancy: what are the risks and should we use a shared decision-making approach?
Review in BMC pregnancy and childbirth, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
37 citing papers in PubMed, 1 synthesis or guideline pooled it, 114 citations in OpenAlex.
- Efficacy and safety of pharmacological treatments in borderline personality disorder: A systematic review and network meta-analysis.Molecular psychiatry · 2026Pooled it
- Evaluation of colostrum-coated ZnO nanoparticles (C-ZnONPs) in attenuating valproic acid-induced prenatal toxicity.Naunyn-Schmiedeberg's archives of pharmacology · 2026Article
- A Comprehensive Review of the Genetic Etiology and Management of Orofacial Clefts.Pediatric discovery · 2026Review
- Capability, opportunity and motivation for shared decision-making about valproate as an antiseizure medication treatment for epilepsy in women with pregnancy potential: A qualitative study of patient perspectives.British journal of health psychology · 2026Article
- Pregnancy, baby, and childhood outcomes from using anti-seizure medication during pregnancy.Communications medicine · 2025Article
- Effects of Antiseizure Medications on Second-Trimester Prenatal Screening Test Parameters: A Retrospective Cohort Study.Medicina (Kaunas, Lithuania) · 2025Article
- Valproic acid-induced teratogenicity is driven by senescence and prevented by Rapamycin in human spinal cord and animal models.Molecular psychiatry · 2025Article
- Dual strategies for epilepsy management employing pharmacological and non-invasive brain stimulation approaches.Frontiers in neurology · 2025Review
- Psychotropic prescribing patterns during pregnancy in two South African mental health clinics.Journal of the colleges of medicine of South Africa · 2025Article
- Contraceptive use and counselling in women with mental illness: KwaZulu-Natal, South Africa.The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa · 2025Article
- Advances in Migraine Treatment: A Comprehensive Clinical Review.Current protein & peptide science · 2025Review
- Prevalence of polypharmacy and factors impacting psychotropic prescribing patterns in women of childbearing potential at inpatient mental health services in Qatar.Neuropsychopharmacology reports · 2024Article
- Developmental exposure of antibiotics shortens life span and induces teratogenicity inToxicology reports · 2024Article
- Advances in Psychotropic Treatment for Pregnant Women: Efficacy, Adverse Outcomes, and Therapeutic Monitoring.Journal of clinical medicine · 2024Review
- A quality of care assessment for women of childbearing potential with epilepsy in Bhutan: An observational study.Epilepsy & behavior : E&B · 2024Observational
- Review
- Three Decades of Valproate: A Current Model for Studying Autism Spectrum Disorder.Current neuropharmacology · 2024Review
- The valproate prescription pattern for female mental healthcare users of reproductive age.The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa · 2024Article
- Global trends and hotspots in pain associated with bipolar disorder in the last 20 years: a bibliometric analysis.Frontiers in neurology · 2024Article
- Countering the declining use of lithium therapy: a call to arms.International journal of bipolar disorders · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundDespite significant teratogenic risks, sodium valproate is still widely prescribed in many countries to women of childbearing age, as a mood stabiliser in bipolar disorder and also in epilepsy. The UK has recently banned valproate use in women who are not in a pregnancy prevention programme. Whilst this ruling reflects prevailing clinical practice, it also highlights an ongoing debate about when (if ever) a woman who is or could become pregnant should be allowed to choose to take valproate. MAIN BODY: We review the benefits and harms of drugs available for bipolar disorder and epilepsy in women of childbearing age, with a particular focus on teratogenic risk. We speculate on hypothetical rare situations in which potential benefits of valproate may outweigh potential harms in such women. We also review the literature on shared decision-making - on which there is now a NICE guideline and numerous evidence-based decision tools. Drawing on previous work by experts in shared decision-making, we offer a list of 'frequently asked questions' and a matrix of options to support conversations with women about continuing or discontinuing the drug in (or in anticipation of) pregnancy. We also consider whether shared decision-making is an appropriate paradigm when considering whether to continue a teratogenic drug.
conclusionWe conclude that because valproate in pregnancy remains the subject of such debate, there is scope for further research - not only into the relative efficacy and safety of alternatives to it - but also into the dynamics of communication and shared decision-making in this situation.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.