Research published in the American Journal of Medical Genetics describes the cases of two siblings with fetal valproate syndrome and their long-term follow-up. The results of research into the effects of children being exposed to valporic acid during pregnancy were also published.
Dr Chahira Kozma from Georgetown University Medical Center in Washington reported that both children had "craniofacial findings, multiple systemic and orthopedic abnormalities, an overgrowth pattern, and developmental deficits" in terms of motor, speech, cognitive, adaptive, and language function skills.
Dr Kozma found 69 cases between 1978 and 2000 of fetal valproate syndrome that could be attributed solely to valproic acid exposure.
Musculoskeletal abnormalities were found in 62 per cent of cases, minor skin defects in 30 per cent, cardiovascular problems occurred in 26 per cent of such children, genital abnormalities in 22 per cent and pulmonary abnormalities in 16 per cent of cases.
The research found that 12 per cent of children died in infancy, and of the surviving children, 29 per cent had developmental defects or learning disabilities.
"All women with epilepsy should be advised that uncontrolled epilepsy is associated with maternal and fetal risk and that the incidence of malformations in their infants following treatment with anticonvulsants is two to three times higher than the general newborn population," Dr. Kozma recommends.
If valproic acid treatment is unavoidable, she suggests that the mother receive a low dose administered several times a day, along with a diet fortified with folate, and the foetus should undergo detailed testing with ultrasound and amniocentesis to detect any limb or systemic abnormalities.