Fetal valproate syndrome
- Embryofoetal valproic acid syndrome
- Valproic acid embryopathy
- Valproic acid fetal effects from
Your QuestionMy child may have fetal valproate syndrome. I'd like to learn more about this syndrome including how it is diagnosed, its symptoms, and treatment.
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Symptom and symptom severity varies from person to person. Risks for harmful effects due to prenatal exposure to valproic acid are likely influenced by a variety of factors, including drug dosage, multiple drug or drug combination, timing of drug exposure, severity of seizure disorder in the mother, predisposing genes, and folic acid intake. In general, children of women with a seizure disorder also are at an increased risk for having a seizure disorder themselves. Parental factors such as IQ and socio-economic status may also play a role in symptom and symptom severity.
Signs and symptoms associated with fetal valproate exposure that have been described in medical literature are listed below by body system. Please note that some of these symptoms have been reported in only a few or a single case (these symptoms are marked with an asterisk).
Ventricular septal defect
Atrial septal defect
Patent ductus arteriosus
*Anomalous right pulmonary artery
Radial ray defects
Extra digit (polydactyly)
Camptodactyly (unusual curvature of the fingers)
Flat feet in childhood
Joint laxity (loose joints)
*Underdevelopment of the ulna or tibia
Central nervous system (brain and spinal cord)
Neural tube defects
*Partial agenesis of corpus callosum
*Abscence of the septum pellucidum
*Lissencephaly of medial sides of occipital lobes
Low verbal IQ
Autism and autistic spectrum disorder
Coloboma of the iris/optic disc
*Underdevelopment of the optic nerve
*Tear duct anomalies
* Very small or poorly developed eyes (microphthalmia)
Hearing problems due to recurrent ear infections
In addition, newborns who were exposed prenatally to seizure medications may require special care after delivery because of withdrawal symptoms. Withdrawal symptoms include feeding difficulties, low blood sugar (hypoglycemia), jitteriness, irritability, and low body temperature (hypothermia). Other symptoms may include poor muscle tone, and joint laxity.
Some children with fetal valproate syndrome show delays in development, autistic features, and/or intellectual disability. In general, the most commonly affected developmental aspect is speech and language. In addition some children have motor delays which may cause clumsiness and impair daily living skills, such as getting dressed, handwriting, riding a bike and swimming. Toilet-training may also be delayed, however most children do achieve this milestone. Lastly, some children with fetal valproate syndrome have difficulty with social interaction, which may prompt investigation for autistic spectrum disorder.
In general, children with fetal valproate syndrome who show delays in comprehension and expression of speech, may be benefited by early speech therapy. Physiotherapy may benefit children with motor delays. Also some children with fetal valproate syndrome may require extra help in school. The following resource may be helpful for families with a child with developmental, learning, or behavioral issues.
National Dissemination Center for Children with Disabilities
P.O. Box 1492
Washington, DC 20013
Toll free/TTY: (800) 695-0285
Fax: (202) 884-8441
Web site: http://www.nichcy.org
- Kini U et al. Dysmorphic features: an important clue to the diagnosis and severity of fetal anticonvulsant syndromes. Arch Dis Child Fetal Neonatal Ed. 2006;
- Kini U. Fetal valproate syndrome: a review. Paediatric and Perinatal Drug Therapy. 2006;
- Clayton-Smith J, Donnai D. Fetal valproate syndrome. J Med Genet. 1995;
- Kozma. Valproic acid embryopathy: Report of two siblings with further expansion of the phenotypic abnormalities and a review of the literature. American Journal of Medical Genetics. 2001;
- Nicolai J, Vles JSH, Aldenkamp AP. Neurodevelopmental delay in children exposed to antiepileptic drugs in utero: A critical review directed at structural study-bias. Journal of the Neurological Sciences. 2008;