Prenatal valproate exposure is associated with autism spectrum disorder and childhood autism

摘要

Main Results Of 655 615 children born from 1996 through 2006, 5437 were identified with autism spectrum disorder, including 2067 with childhood autism. The mean age of the children at end of follow-up was 8.84 years (range, 4-14; median, 8.85). The estimated absolute risk after 14 years of follow-up was 1.53% (95% CI, 1.47%-1.58%) for autism spectrum disorder and 0.48% (95% CI, 0.46%-0.51%) for childhood autism. Overall, the 508 children exposed to valproate had an absolute risk of 4.42% (95% CI, 2.59%-7.46%) for autism spectrum disorder, adjusted hazard ratio (HR), 2.9 (95% CI, 1.7-4.9) and an absolute risk of 2.50% (95% CI, 1.30%-4.81%) for childhood autism, adjusted HR, 5.2 (95% CI, 2.7-10.0). When restricting the cohort to the 6584 children born to women with epilepsy, the absolute risk of autism spectrum disorder among 432 children exposed to valproate was 4.15% (95% CI, 2.20%-7.81%), adjusted HR, 1.7 (95% CI, 0.9-3.2), and the absolute risk of childhood autism was 2.95% (95% CI, 1.42%-6.11%), .adjusted HR, 2.9 (95% CI, 1.4-6.0) vs 2.44% (95% CI, 1.88%-3.16%) for autism spectrum disorder and 1.02% (95% CI, 0.70%-1.49%) for childhood autism among 6152 children not exposed to valproate.