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Female paediatric patients with epilepsy who continue to receive valproate in the UK
  1. Lilly Lang1,2,
  2. Neisha Dunbar-Creasey3,
  3. Rachel Kneen3,
  4. Laura Neely3,
  5. Daniel B Hawcutt1,4
  1. 1 Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
  2. 2 University of Liverpool Medical School, Liverpool, UK
  3. 3 Department of Neurology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
  4. 4 Alder Hey Clinical Research Facility, Alder Hey Children's Hospital, National Institute for Health Research, Liverpool, UK
  1. Correspondence to Dr Daniel B Hawcutt, Alder Hey Clinical Research Facility, Alder Hey Children's Hospital, National Institute for Health Research, Liverpool L12 2AP, UK; dhawcutt{at}

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Valproate, while an effective antiepileptic medication, has considerable teratogenic risks. There is a 10% risk of congenital malformations and a 30–40% risk of neurodevelopmental disorders in the developing fetus.1 ‘Fetal Valproate syndrome’ describes the variety of disorders caused by exposure to valproate in utero, including: neural tube defects such as spina bifida, dysmorphic features, intellectual disability and autism spectrum disorder.2 In response, the Medicines and Healthcare products Regulatory Agency introduced the pregnancy prevention programme (PPP),3 detailing new regulations surrounding valproate prescription in order to restrict its use among female patients of childbearing potential and enforce strict criteria on those who continue taking valproate. Postmenarchal females should only be prescribed valproate in the …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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