ArticleDrug safety2021
Understanding and Responding to Prescribing Patterns of Sodium Valproate-Containing Medicines in Pregnant Women and Women of Childbearing Age in Western Cape, South Africa.
Article in Drug safety, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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.
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.
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Who cites it
9 citing papers in PubMed, 13 citations in OpenAlex.
- Evaluation of the management of high-risk obstetric patients living with epilepsy: A retrospective study from KwaZulu-Natal, South Africa.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2026Article
- A profile of psychotropic medication in bipolar patients of reproductive age.The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa · 2026Article
- Antiseizure medications consumption in 73 countries and regions from 2012 to 2022: a longitudinal trend study.EClinicalMedicine · 2025Article
- Challenges to epilepsy management in Rwandan women living with epilepsy.European journal of neurology · 2024Article
- 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
- The burden, prevention and care of infants and children with congenital anomalies in sub-Saharan Africa: A scoping review.PLOS global public health · 2023Article
- Review
- Article
- A description of sodium valproate, lamotrigine and levetiracetam consumption in the Western Cape public sector.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2022Observational
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
Abstract
introductionGrowing evidence of the teratogenic potential of sodium valproate (VPA) has changed prescribing practices across the globe; however, the impact of this research and the consequent dissemination of a Dear Health Care Professional Letter (DHCPL) in December 2015, recommending avoidance of the teratogen VPA in women of childbearing age (WOCBA) and pregnant women in South Africa, is unknown. We explored trends and reasons for VPA use among pregnant women and WOCBA in the public sector in Western Cape Province from 1 January 2015 to 31 December 2017.
methodsUsing the provincial health information exchange that collates routine electronic health data via unique patient identifiers, we analysed clinical and pharmacy records from 2015 to 2017 to determine prescription patterns of VPA and other antiepileptic drug (AED) and mood-stabilising medicine (MSM) use in WOCBA and pregnant women. Senior clinicians and policy makers were consulted to understand the determinants of VPA use.
resultsAt least one VPA prescription was dispensed to between 8205 (0.79%) and 9425 (0.94%) WOBCA from a cohort of approximately 1 million WOCBA attending provincial health care facilities per year. Prescriptions were more likely in HIV-infected women compared with HIV-uninfected women (1.1-1.3% vs. 0.7-0.9%; p < 0.001). VPA use in WOCBA remained stable at 0.8-0.9% over the review period despite the 2016 DHCPL. VPA was the most prescribed AED/MSM, constituting 43.2-45.5% of all WOCBA taking at least one such agent, while lamotrigine, the other recommended first-line agent, was only prescribed in 7.8-8.9% of WOCBA. Over 3 years, approximately 663 pregnancies were exposed to VPA, with a steady rise in the number of exposures each year (n = 204, 214 and 245, respectively).
conclusionDespite warnings, VPA remained the most frequently prescribed AED or MSM in WOCBA. Contributing factors are described.
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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.