Takeaway
Prenatal exposure to the antiepileptic drug (AED) valproic acid (VPA) negates the usual predominance of males in the incidence of autism spectrum disorder (ASD), furthering the idea of VPA as a “behavioral teratogen”. There was no impact found on attention-deficit hyperactivity disorder (ADHD).
Why this matters
Pregnancy is a challenging issue for women with epilepsy, due to the potentially harmful effects of AEDs on the unborn fetus. Prenatal exposure to the commonly used AED VPA confers a 10% risk of major congenital malformations and a 48% increased risk of ADHD.
In the general population, males are up to 4 times more likely to have ASD than females, a relationship which has also been applied to ADHD.
The sex-specific effects of VPA in neurodevelopment and the relationship with ASD and ADHD are yet to be elucidated.