AUTISM SPECTRUM DISORDERS FOLLOWING IN UTERO EXPOSURE TO ANTIEPILEPTIC DRUGS
Open accessAbstract
BACKGROUND The purpose of this study was to investigate changes in breathing pattern, neuromuscular drive (P0.1), and activity of the sternocleidomastoid muscles (SCM) during a gradual reduction in pressure support ventilation (PSV) in patients being weaned off controlled mechanical ventilation. METHODS Eight non-COPD patients recovering from acute respiratory failure were included in this prospective interventional study. All patients were unable to tolerate discontinuation from mechanical ventilation. Each patient was evaluated during a period of spontaneous breathing and during PSV. Four successive levels of PSV were assessed in the following order: 20 cm H2O (PS20), 15 cm H2O (PS15), 10 cm H2O (PS10), and 5 cm H2O (PS5). RESULTS When pressure support was reduced from PS20 to PS10 the respiratory rate (f) and the rapid shallow breathing index (f/Vt) significantly increased and tidal volume (Vt) significantly decreased. These parameters did not vary when pressure support was reduced from PS10 to PS5. Conversely, P0.1 varied negligibly between PS20 and PS15 but increased significantly at low PSV levels. P0.1 values were always greater than 2.9 cm H2O (4.1 (1.1) cm H2O) when SCM activity was present. When contraction of the SCM muscles reappeared the P0.1 was the only parameter that changed significantly. CONCLUSIONS In postoperative septic patients the value of P0.1 seems to be more useful than breathing pattern parameters for setting the optimal level of pressure assistance during PSV.
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Children exposed to valproate in utero were seven times more likely to develop autism than those not exposed to antiepileptic drugs.
“Thus, children exposed to valproate in utero were seven times more likely to develop autism than those not exposed to antiepileptic drugs (61, 62).”
From Gene × Environment Interactions in Autism Spectrum Disorders: Role of Epigenetic Mechanisms (2014) · cites this paper as [61]
A rare consistent association with AD is in utero exposure to two known teratogenic medications, thalidomide and valproate, or the abortifactant misoprostol.
“In addition, concerning the prenatal risk factors for AD, a rare consistent association with AD is in utero exposure to two known teratogenic medications, thalidomide, and valproate (valproate is a broad-spectrum anticonvulsant drug used in seizures, bipolar disorder, or migraine headache), or the abortifactant misoprostol (7, 61–63).”
From Gene × Environment Interactions in Autism Spectrum Disorders: Role of Epigenetic Mechanisms (2014) · cites this paper as [61]
Infants of mothers taking antiepileptic drugs during pregnancy have been shown to be at increased risk of being diagnosed with ASD and having low 25(OH)D concentrations.
“Infants of mothers taking antiepileptic drugs during pregnancy have been shown to be at increased risk of being diagnosed with ASD and having low 25(OH)D concentrations [193].”
From Vitamin D and Autism Spectrum Disorder: A Literature Review (2016) · cites this paper as [193]
Exposure of pregnant women to VPA, but not other anti-epileptic treatments, nearly triples their risk for having a child with ASD, and ASD-like behavioral phenotypes have been replicated in rodent models of prenatal VPA exposure.
“Exposure of pregnant women to VPA, but not other anti-epileptic treatments, nearly triples their risk for having a child with ASD [44, 69] and ASD-like behavioral phenotypes have been replicated in rodent models of prenatal VPA exposure (see Supplementary Table 3).”
From Autism spectrum disorder: neuropathology and animal models (2017) · cites this paper as [44]
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References 6 · Cited by 269
- Authors
- Bromley, R. L., Mawer, G., Clayton-Smith, J., & Baker, G. A.
- Affiliations
- University of Liverpool (GB)
- From the Division of Neurosciences (R.L.B., G.A.B.), University of Liverpool; and Department of Clinical Genetics (G.M., J.C.-S.), St Mary's Hospital, Manchester, UK.
- Venue
- Neurology
- Published
- 2008-12-02
- Volume
- 71
- Issue
- 23
- Pages
- 1923-1924
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- OpenAlex
- W2004023355
- Cited by
- 269
- References
- 6
- Citations by year
- 2026: 1 · 2025: 9 · 2024: 10 · 2023: 10 · 2022: 6 · 2021: 12 · 2020: 41 · 2019: 14 · 2018: 11 · 2017: 13 · 2016: 20 · 2015: 17 · 2014: 18 · 2013: 24 · 2012: 16
- FWCI
- 13.78
- Type
- journal article
- Language
- en
- Open access
- Licence
- other-oa
- Locations
- Neurology (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmacological Effects and Toxicity Studies
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Keywords
- autism spectrum disorder, prenatal exposure, antiepileptic drugs, prenatal drug exposure
- MeSH terms
- Adult, Anticonvulsants, Autistic Disorder, Epilepsy, Female, Humans, Male, Pregnancy, Prenatal Exposure Delayed Effects, Retrospective Studies, Young Adult
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