ArticleBMJ (Clinical research ed.)2026
Prenatal antiseizure drug exposure and risk of neurodevelopmental disorders in children: population based cohort study.
Article in BMJ (Clinical research ed.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate whether prenatal exposure to specific antiseizure drugs increases the risk of neurodevelopmental disorders in children.
designPopulation based cohort study.
settingHealthcare use data from publicly and commercially insured beneficiaries in the United States, 2000-21.
participantsPregnant patients with epilepsy linked to offspring.
interventionsDispensing of the antiseizure drug of interest during the second half of pregnancy (synaptogenesis period): carbamazepine, lacosamide, lamotrigine, levetiracetam, oxcarbazepine, phenobarbital, phenytoin, topiramate, valproate, and zonisamide. The reference group consisted of pregnant patients with diagnosed epilepsy, but no antiseizure drug dispensation from three months before pregnancy until delivery. MAIN OUTCOMES MEASURES: Any neurodevelopmental disorder, attention deficit hyperactivity disorder, autism spectrum disorder, behavioral disorder, developmental coordination disorder, intellectual disability, learning difficulty, and speech or language disorder identified using validated algorithms. Hazard ratios were estimated using Cox proportional hazard models with propensity score overlap weighting to adjust for potential confounders.
resultsThe cohort included 8887 children who were prenatally unexposed. Exposed pregnancies ranged from 219 for lacosamide to 5261 for levetiracetam. Valproate and zonisamide showed associations with several outcomes (adjusted hazard ratio range 1.26-4.50), whereas levetiracetam and phenytoin were not associated with an increased risk of any outcome. Several drugs were associated with a two to fourfold risk increase for intellectual disability, but estimates were imprecise because of the small number of children with this disorder. Although no meaningful associations were found for topiramate and lamotrigine across most outcomes, there was a potential signal for intellectual disability (both drugs) and learning difficulty (topiramate only; hazard ratio 1.23 based on small numbers). Carbamazepine and oxcarbazepine showed a modest risk increase for attention deficit hyperactivity disorder and behavioral disorders (hazard ratio range 1.23-1.40). Results were robust across several sensitivity analyses, including using lamotrigine as an active comparator.
conclusionsThe findings strengthen the evidence for increased neurodevelopmental risks among children with prenatal valproate exposure and suggest the need for further evaluation of zonisamide. Signals for other antiseizure drugs, observed in the context of several comparisons and rare outcomes, require confirmation as data accumulate.
Indexed as
Identifiers
What Socratic holds
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 Socratic graph.