Valproic acid prenatal exposure. Association with lipomyelomeningocele
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1Department of Pediatrics, University of Colorado School of Medicine, Denver.
Insights
Maternal use of valproic acid during pregnancy can cause birth defects. This study reports a new association between valproic acid and closed neural tube defects, specifically lipomyelomeningocele, in siblings.
Area of Science:
- Neurology
- Teratology
- Pediatric Surgery
Background:
- Valproic acid is a commonly prescribed anticonvulsant medication.
- Maternal valproic acid use in pregnancy is a known risk factor for open neural tube defects.
- The association with closed neural tube defects remains less understood.
Observation:
- A family presented with two siblings exhibiting different congenital malformations.
- Both siblings were exposed to maternal valproic acid and other anticonvulsants during gestation.
- One sibling was diagnosed with a lipomyelomeningocele, a type of closed neural tube defect.
Findings:
- This case report details a novel association between maternal valproic acid exposure and the development of closed neural tube defects, specifically lipomyelomeningocele.
- The findings suggest valproic acid may contribute to a broader spectrum of neural tube defects than previously recognized.
- Sibling malformations highlight potential genetic or environmental factors interacting with teratogenic exposures.
Implications:
- The findings underscore the importance of counseling pregnant individuals on the risks of valproic acid and other anticonvulsants.
- Early recognition and surgical intervention for lipomyelomeningocele are crucial for optimal patient outcomes.
- Further research is warranted to elucidate the mechanisms underlying valproic acid-induced teratogenicity and its impact on various neural tube defect types.
Abstract:
Valproic acid is an anticonvulsant that has been associated with open neural tube defects. We report a family in which the maternal use of valproic acid, and other anticonvulsants, during pregnancy resulted in different malformations in two siblings, one of which had a lipomyelomeningocele. The association of valproic acid and closed neural tube defects has not previously been reported. A brief review of the teratogenic effects of valproic acid is included as well as the implications for early surgical management of lipomyelomeningocele.