Neurodevelopmental outcomes in children and adults with Fetal Valproate Spectrum Disorder: A contribution from the ConcePTION project.

Bluett-Duncan, M; Astill, D; Charbak, R; Clayton-Smith, J; Cole, S; Cook, P A; Cozens, J; Keely, K; Morris, J; Mukherjee, R; Murphy, E; Turnpenny, P; Williams, J; Wood, A G; Yates, L M; Bromley, R L

Abstract

To describe the neurodevelopmental phenotype of older children and adults with a diagnosis of Fetal Valproate Spectrum Disorder (FVSD). In this cross-sectional study, 90 caregivers were recruited and completed a series of questionnaires regarding the neurodevelopmental outcomes of 146 individuals aged 7-37years (M=18.1), including individuals with a formal diagnosis of FVSD (n=99), individuals exposed to Valproate but without an FVSD diagnosis (n=24), and individuals not exposed to Valproate (N=23). The mean dose of valproate exposure for individuals with an FVSD diagnosis was 1470mg/day. Individuals with a diagnosis of FVSD showed significantly higher levels of moderate (43.4%) and severe (14.4%) cognitive impairment than other groups (p=0.003), high levels of required formal educational support (77.6%), and poorer academic competence than individuals not exposed to Valproate (p=0.001). Overall psychosocial problems (p=0.02), internalising problems (p=0.05) and attention problems (p=0.001), but not externalising problems, were elevated in individuals with a diagnosis of FVSD. Rates of neurodevelopmental disorders, particularly autistic spectrum disorders (62.9%) and sensory problems (80.6%) are particularly central to the FVSD phenotype. There was no evidence of a statistical dose-dependent effect, possibly due to the high mean dose of exposure having a uniformly negative impact across the sample. Individuals with FVSD had required a significant number of health and child development services. Children and young adults with a diagnosis of FVSD are at an increased risk of a range of altered neurodevelopmental outcomes, highlighting the need for a multidisciplinary approach to clinical management across the lifespan. [Abstract copyright: Copyright © 2023. Published by Elsevier Inc.]

Citation

Bluett-Duncan, M., Astill, D., Charbak, R., Clayton-Smith, J., Cole, S., Cook, P. A., …Bromley, R. L. (2023). Neurodevelopmental outcomes in children and adults with Fetal Valproate Spectrum Disorder: A contribution from the ConcePTION project. Neurotoxicology and Teratology, 100, 107292. https://doi.org/10.1016/j.ntt.2023.107292

• Journal Article Type: Article
• Acceptance Date: Sep 1, 2023
• Online Publication Date: Sep 4, 2023
• Publication Date: Sep 8, 2023
• Deposit Date: Sep 5, 2023
• Publicly Available Date: Sep 11, 2023
• Journal: Neurotoxicology and teratology
• Print ISSN: 0892-0362
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 100
• Pages: 107292
• DOI: https://doi.org/10.1016/j.ntt.2023.107292
• Keywords: Cognition, Epilepsy, Teratology, Neurodevelopment, Fetal Valproate Spectrum Disorder, Sodium Valproate