ArticleBMJ open2020
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.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 4 of them syntheses that pooled it.
What it found
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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.
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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.
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Who cites it
37 citing papers in PubMed, 4 syntheses or guidelines pooled it, 83 citations in OpenAlex.
- Risk of neurodevelopmental disorders after fetal topiramate exposure: a systematic review.Frontiers in drug safety and regulation · 2026Pooled it
- Effect of Benzodiazepines and Z-Drug Medications During Antenatal and Postnatal Depression and Anxiety: A Systematic Review and Meta-Analysis.Combinatorial chemistry & high throughput screening · 2025Pooled it
- Prenatal exposure to pregabalin, birth outcomes and neurodevelopment - a population-based cohort study in four Nordic countries.Drug safety · 2023Pooled it
- A systematic review of the biological, social, and environmental determinants of intellectual disability in children and adolescents.Frontiers in psychiatry · 2022Pooled it
- The SANAD II study of the effectiveness and cost-effectiveness of valproate versus levetiracetam for newly diagnosed generalised and unclassifiable epilepsy: an open-label, non-inferiority, multicentre, phase 4, randomised controlled trial.Lancet (London, England) · 2021Trial
- Associations between maternal sleep disorders and long-term neurodevelopmental disorders in children: evidence from a national cohort of 1.9 million births.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2026Article
- Long-term neurodevelopmental and psychiatric risks after general anesthesia in early childhood: a nationwide population-based cohort study.Journal of anesthesia · 2026Article
- [Pain management during pregnancy : A balancing act between benefits and risks].Schmerz (Berlin, Germany) · 2026Review
- Prenatal antiseizure drug exposure and risk of neurodevelopmental disorders in children: population based cohort study.BMJ (Clinical research ed.) · 2026Article
- Association between prenatal opioid exposure and long-term neurodevelopmental disorders among children: a nationwide cohort study : Prenatal opioid exposure and neurodevelopment.BMC pediatrics · 2026Article
- Prenatal exposure to oral glucocorticoids and risk of long-term neurodevelopmental disorders.Scientific reports · 2026Article
- Pregnancy, baby, and childhood outcomes from using anti-seizure medication during pregnancy.Communications medicine · 2025Article
- Paternal Valproate Use and Neurodevelopmental Disorder and Congenital Malformation Risk in Offspring.JAMA network open · 2025Observational
- Valproate-Induced Autism and Sexual Hormone Disturbances: A Literature Review and Hypotheses.Neurochemical research · 2025Review
- A Scoping Review of Human Teratogens and Their Impact on the Developing Brain: A Contribution From the ConcePTION Project.Birth defects research · 2025Article
- Trends in Prenatal Exposure to Antiseizure Medications Over the Past Decade: A Nationwide Study.Neurology · 2025Article
- Review
- Prenatal exposure to psychotropics and analgesics on cognitive, linguistic and educational outcomes - a scoping review with focus on validity and reliability of outcome measures.BMC pregnancy and childbirth · 2025Article
- Neurobehavioral Outcomes of Children with Antenatal Exposure to Antiseizure Medications.Indian journal of pediatrics · 2025Article
- Dosing Optimization of Lamotrigine in Peripregnancy Epilepsy Through PopPK Modelling and Simulation.Drug design, development and therapy · 2025Article
Corrections and comments
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Authors and funding
9 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo assess the association between prenatal exposure to monotherapy with the antiepileptic drugs (AEDs) most commonly used during pregnancy and the risk of various neurodevelopmental outcomes compared with lamotrigine.
designNationwide population-based cohort study.
settingFrench national healthcare databases.
participantsChildren born alive between 2011 and 2014 and prenatally exposed to AED monotherapy. PRIMARY AND SECONDARY OUTCOME MEASURES: Outcomes included neurodevelopmental disorders (NDD), defined by International Classification of Diseases, 10th Revision codes F70-F98-pervasive developmental disorders (PDD, F84) and mental retardation (MR, F70-F79) were studied separately-and visits to speech therapists. The reference group comprised children prenatally exposed to lamotrigine. Children were followed until outcome, loss to follow-up, death or 31 December 2016. We performed inverse probability of treatment weighting analyses using the propensity score, which included maternal and infant characteristics. Hazard ratios (HRs) were calculated using Cox models.
resultsThe cohort comprised 9034 children, 2916 of which were exposed to lamotrigine, 1627 to pregabalin, 1246 to clonazepam, 991 to valproic acid (VPA), 621 to levetiracetam, 502 to carbamazepine, 477 to topiramate, 378 to gabapentin and 143 to oxcarbazepine. None of these AEDs, except VPA, was associated with an increased risk of any of the four neurodevelopmental outcomes investigated. Exposure to VPA was associated with increased risks of NDDs (HR=2.7, 95% CI (1.8 to 4.0)), PDD (HR=4.4 (2.1 to 9.3)), MR (HR=3.1 (1.5 to 6.2)) and visits to speech therapists (HR=1.5 (1.1 to 1.9)), with a dose-response relationship.
conclusionsNo increased risk of any of the neurodevelopmental outcomes investigated in this study was observed with prenatal exposure to levetiracetam, pregabalin, oxcarbazepine, topiramate, gabapentin, clonazepam or carbamazepine, compared with lamotrigine. However, this study corroborates the well-known association between maternal use of VPA during pregnancy and the risk of neurodevelopmental disorders in the offspring. Longer follow-up is necessary to confirm these findings.
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