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Whether you are pregnant or are planning to get pregnant, you will want to give your baby a healthy start. During pregnancy, regular visits with your health care provider are very important for your baby and yourself. You will also need to drink plenty of fluids and eat a healthy diet. But, what you don’t expose your body to is almost as important as what you do.

It is well known that alcohol consumption, recreational drugs, and cigarette smoking increase the risk for premature birth, poor growth, birth defects, and behavior and learning problems. You will also want to limit or avoid caffeine and steer clear of certain foods, such as unpasteurized cheeses, milk and juices, raw eggs, raw or undercooked meats, and certain types of fish and shellfish that could carry food-borne illnesses like listeriosis and toxoplasmosis, which can be life-threatening to an unborn baby and may cause birth defects or miscarriage. Even common over-the-counter medications that are generally safe may be considered off-limits during pregnancy, as well as certain prescription medications because of their potential effects on the baby.

Drugs used to treat epilepsy have been linked with an increased risk of birth defects, such as spina bifida and heart malformations. A new study shows that pregnant women who take the epilepsy drug valproate may significantly increase the risk of their child developing autism, a complex developmental disability that affects a person’s ability to communicate and interact with others.

The ongoing study involved 632 children, almost half of whom were exposed to epilepsy drugs in utero. Of those children, 64 were exposed to valproate, 44 to lamotrigine, 76 to carbamazepine, and 65 to other epilepsy drugs or combinations of drugs. Forty-seven children were not exposed to any anti-seizure drugs. The children were tested for autism at one, three, and six years of age. None of the children had a family history of autism.

The study found that 7 of the children diagnosed with autism had mothers who took an epilepsy drug while pregnant; 4 of those children were exposed to valproate, while the mother of a 5th child took a combination of valproate and lamotrigine. Children whose mothers were taking valproate alone for epilepsy were seven times more likely to develop autism, compared to children whose mothers did not have epilepsy and were not taking any drug while pregnant. However, the risk seen with valproate was not seen with the other epilepsy drugs. “The potential risk for autism in this study was substantial for children whose mothers took valproate while pregnant, but more research needs to be done since these are early findings,” said study author Gus Baker, Ph.D., FBPsS, of the University of Liverpool in England.

The reactions of experts are divided. Page Pennell, M.D., director of the epilepsy program at Emory University in Atlanta, says the study suggests the need to “consider exposure throughout the entire pregnancy” and even before conception. Dr. Pennell says half of the pregnancies in the U.S. are unplanned, so women of childbearing age should steer clear of valproate unless it’s the only medication that controls seizures. “Most of these women unfortunately have to be on a medicine. But the idea is: women of childbearing age should be on another anti-epileptic drug.”

Conversely, Dr. Michael Goldstein, vice president of the American Academy of Neurology, says that while doctors are aware that some anti-seizure drugs can cause abnormalities in the brain, pregnant women with epilepsy often have to choose between the lesser of two risks. “Prolonged seizure could cause blood flow problems to the baby, which could cause injury,” he said. “We generally try to avoid valproic acid in women who might be pregnant. But for some women who have difficulty in controlling epilepsy, they’re better off taking the medicine than having seizures. The consensus is that seizures are worse for the babies than the medicine.”

Laureen Cassidy, a vice president for Abbott Laboratories, the makers of the brand name valproic acid drug called Depakote, echoes the point. “Uncontrolled seizures can cause permanent damage to the brain and for pregnant women can be fatal for both mother and child.” She added that “the Depakote product label makes it clear that it should not be used as a first-line treatment for women of childbearing age. For many women, however, Depakote may be the only effective seizure medication and that decision should be made between the patient and physician.” Raquel Powers, another spokeswoman for the company, said it’s a global drug and that its risks are well known.

Dr. Baker said, “women who take valproate while pregnant should be informed of the possible risks of autism and are encouraged to discuss them with their doctor.” He also urges those who are taking valproate not to stop their treatment without speaking to their doctor first.

Source: Healthnews.com

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