Beyond congenital anomalies, the impact of sodium valproate exposure in utero on long‐term health and well‐being: A contribution from the
ConcePTION
project
P. A. Wells, J. L. Richardson, D. Astill, M. Bluett‐Duncan, R. L. Bromley, J. Clayton‐Smith, S. Cole, J. Cozens, K. Keely, J. Morris, E. Murphy, P. D. Turnpenny, J. Williams, L. M. Yates Abstract
Objective
Sodium valproate (VPA) is an established teratogen that is prescribed worldwide. Although congenital anomalies and neurodevelopmental impairments are well described in those affected by in utero VPA exposure, limited data are available regarding the physical health impacts. We aimed to document, via caregiver reporting, the physical health outcomes for a cohort of in utero VPA‐exposed individuals compared with an unexposed group.
Methods
This cross‐sectional observational study collected primary data via questionnaire from primary caregivers of individuals exposed and unexposed to VPA in utero. Information collected related to maternal health, pregnancy, offspring health and neurodevelopment. Participants were recruited from the UK, Ireland, New Zealand, the United States, and Australia. Reported physical health was compared between those exposed to VPA monotherapy in utero ( n = 88) and an unexposed group ( n = 18).
Results
Physical health concerns were reported in a median of 6 of 12 organ systems for those with VPA exposure of 1000 mg per day or greater, 5 systems with exposure less than 1000 mg VPA per day, and 1 in the unexposed group. The VPA‐exposed group reported poorer health ( p < .001), increased difficulty ( p < .001), pain or distress ( p < .001), and increased limitation of daily activities ( p < .001). Reported health complaints were wide ranging and extended beyond congenital anomalies.
Significance
This study highlights increased reporting of physical health challenges in those exposed to VPA in utero, the multimorbidity impact of which affects quality of life and can persist into adulthood. Further study is warranted to ascertain accurate prevalence of these symptoms among individuals harmed by VPA in utero.