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Valproate is used in the management of seizures, migraines, and bipolar disorder, but its known association with congenital malformations is problematic for women who are pregnant or may become pregnant. Two recent studies shed more light on the risks associated with valproate and clinician prescribing patterns.
In a population-based cohort study from Korea, infants exposed to valproate had the highest overall risk for congenital malformations compared with other antiseizure medications (odds ratio, 1.5), and the risk was significant for cleft palate without cleft lip. Lamotrigine and levetiracetam were associated with the least risk.
In a U.S. study of survey data from females 12 to 49 years of age (collected between 2017 a…