Risk of Autism after Prenatal Topiramate, Valproate, or Lamotrigine Exposure

This study investigated autism risk in children prenatally exposed to antiseizure medications. A population-based cohort using U.S. Medicaid and commercial insurance data (2000–2020) compared autism incidence in children exposed during pregnancy to topiramate valproate, or lamotrigine. Among children of mothers with epilepsy, adjusted hazard ratios for autism were:

• Topiramate: 0.96 (95% CI, 0.56 to 1.65) — no significant increase

• Valproate: 2.67 (95% CI, 1.69 to 4.20) — increased risk

• Lamotrigine: 1.00 (95% CI, 0.69 to 1.46) — no significant increase
  The study concludes valproate is associated with increased autism risk, while topiramate and lamotrigine are not, after adjustment for confounders.

This study investigated autism risk in children prenatally exposed to antiseizure medications. A population-based cohort using U.S. Medicaid and commercial insurance data (2000–2020) compared autism incidence in children exposed during pregnancy to topiramate valproate, or lamotrigine. Among children of mothers with epilepsy, adjusted hazard ratios for autism were:

• Topiramate: 0.96 (95% CI, 0.56 to 1.65) — no significant increase

• Valproate: 2.67 (95% CI, 1.69 to 4.20) — increased risk

• Lamotrigine: 1.00 (95% CI, 0.69 to 1.46) — no significant increase
  The study concludes valproate is associated with increased autism risk, while topiramate and lamotrigine are not, after adjustment for confounders.