Epilepsy Drug Autism Risk May Be Lowered by Folic Acid Supplements: Study

Anti-epileptic medications are known to increase the risk of a child having autism when taking during pregnancy, however use of folic acid supplements may reduce that risk, according to the findings of new research. 

In a study published last week in the medical journal JAMA Neurology, researchers indicate that children of women who were taking anti-epileptic drugs and folic acid during pregnancy had a lower risk of developing autistic traits than children of women who were only taking anti-epileptic drugs.

Researchers from the Norwegian Mother and Child Cohort Study, seeking strategies to prevent autism in children exposed to anti-epileptic drugs during pregnancy, looked at data of Norwegian speaking pregnant women attending routine ultrasound appointments from June 1999 to December 31, 2008.

The data included nearly 105,000 children ages 18 to 36 months. Mothers were given questionnaires during and after pregnancy, blood samples were analyzed, and medical data from the birth Registry of Norway was used. Mothers were either taking anti-epileptic drugs during pregnancy or had untreated epilepsy. Some were also taking folic acid.

Mothers took folic acid supplements four weeks before conception, then up to 12 weeks after conception. Autistic traits were evaluated using the Modified Checklist for Autism in Toddlers and Social Communication Questionnaire.

According to the findings, children exposed to anti-epileptic drugs in utero had a significantly lower risk of autistic traits if the mother also used folic acid supplements during pregnancy. The findings indicate that the higher the level of folate concentration in a woman’s blood during gestational weeks 17 to 19, the lower the risk of the degree of autistic traits.

Among the 335 children exposed to anti-epileptic drugs and whose mothers did not take folic acid, their risk for autistic traits was higher at 18 months and 36 months. Their adjusted odds ratio was 5.9 at 18 months and 7.9 at 36 months.

Children without epilepsy had a lower risk of autism at 18 months and 36 months of age. For women without epilepsy, their adjusted odds ratio of having children with autistic traits was 1.3 at 18 months and 1.7 at 36 months.

Of the nearly 400 children of women with untreated epilepsy, they did not have a significantly increased risk at 18 months and 36 months of age. Those patients did not take anti-epileptic drugs to treat the condition.

Study authors emphasized women of childbearing age who are taking anti-epileptic drugs should take folic acid continuously to reduce their child’s risk later after pregnancy.

This isn’t the first study to evaluate the side effects of anti-epileptic drugs during pregnancy.  A 2013 study indicated that drugs like Depakote and Lamictal, may increase the risk of birth defects, including premature birth, low birth weight, abnormally small head and other congenital birth defects.

Another report issued in 2017 indicated more than 4,000 children from France suffered birth defects after their mothers took antiepileptic drugs during pregnancy. Side effects included neurological defects and birth defects, like spina bifida, malformed limbs, and holes in the heart.