{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T09:58:22Z","timestamp":1790675902882,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Sodium valproate (VPA) is an established teratogen that is prescribed worldwide. Although congenital anomalies and neurodevelopmental impairments are well described in those affected by in utero VPA exposure, limited data are available regarding the physical health impacts. We aimed to document, via caregiver reporting, the physical health outcomes for a cohort of in utero VPA\u2010exposed individuals compared with an unexposed group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This cross\u2010sectional observational study collected primary data via questionnaire from primary caregivers of individuals exposed and unexposed to VPA in utero. Information collected related to maternal health, pregnancy, offspring health and neurodevelopment. Participants were recruited from the UK, Ireland, New Zealand, the United States, and Australia. Reported physical health was compared between those exposed to VPA monotherapy in utero (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200988) and an unexposed group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200918).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Physical health concerns were reported in a median of 6 of 12 organ systems for those with VPA exposure of 1000\u2009mg per day or greater, 5 systems with exposure less than 1000\u2009mg VPA per day, and 1 in the unexposed group. The VPA\u2010exposed group reported poorer health (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001), increased difficulty (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001), pain or distress (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001), and increased limitation of daily activities (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001). Reported health complaints were wide ranging and extended beyond congenital anomalies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>This study highlights increased reporting of physical health challenges in those exposed to VPA in utero, the multimorbidity impact of which affects quality of life and can persist into adulthood. Further study is warranted to ascertain accurate prevalence of these symptoms among individuals harmed by VPA in utero.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi.70330","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T13:55:18Z","timestamp":1782395718000},"page":"4523-4535","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond congenital anomalies, the impact of sodium valproate exposure in utero on long\u2010term health and well\u2010being: A contribution from the\n                    <scp>ConcePTION<\/scp>\n                    project"],"prefix":"10.1002","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4838-888X","authenticated-orcid":false,"given":"P. A.","family":"Wells","sequence":"first","affiliation":[{"name":"Northern Genetics Service Newcastle upon Tyne Hospitals NHS Foundation Trust  Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. L.","family":"Richardson","sequence":"additional","affiliation":[{"name":"UK Teratology Information Service Newcastle upon Tyne Hospitals NHS Foundation Trust  Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Astill","sequence":"additional","affiliation":[{"name":"Foetal Anti\u2010Convulsant Syndrome New Zealand  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7539-6746","authenticated-orcid":false,"given":"M.","family":"Bluett\u2010Duncan","sequence":"additional","affiliation":[{"name":"Division of Neuroscience University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. L.","family":"Bromley","sequence":"additional","affiliation":[{"name":"Division of Neuroscience University of Manchester  Manchester UK"},{"name":"Division of Neuroscience Royal Manchester Children's Hospital  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Clayton\u2010Smith","sequence":"additional","affiliation":[{"name":"Division of Evolution, Systems and Genomics University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Cole","sequence":"additional","affiliation":[{"name":"Pharma Consent  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Cozens","sequence":"additional","affiliation":[{"name":"OACS (Organisation for Anti\u2010Convulsant Syndrome)  Caerphilly UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Keely","sequence":"additional","affiliation":[{"name":"OACS Ireland (Organisation for Anti\u2010Convulsant Syndrome)  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Morris","sequence":"additional","affiliation":[{"name":"Foetal Anti\u2010Convulsant Syndrome New Zealand  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Murphy","sequence":"additional","affiliation":[{"name":"In\u2010FACT (Independent Fetal Anti Convulsant Trust)  Greater Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. D.","family":"Turnpenny","sequence":"additional","affiliation":[{"name":"Clinical Genetics Royal Devon University Healthcare NHS Foundation Trust  Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Williams","sequence":"additional","affiliation":[{"name":"In\u2010FACT (Independent Fetal Anti Convulsant Trust)  Greater Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7963-625X","authenticated-orcid":false,"given":"L. M.","family":"Yates","sequence":"additional","affiliation":[{"name":"Northern Genetics Service Newcastle upon Tyne Hospitals NHS Foundation Trust  Newcastle upon Tyne UK"},{"name":"Translational and Clinical Research Institute Newcastle University  Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13023-019-1064-y"},{"key":"e_1_2_13_3_1","unstructured":"European Medicines Agency.New measures to avoid valproate exposure in pregnancy endorsed. EMA\/375438\/2018.2018."},{"key":"e_1_2_13_4_1","unstructured":"Crown Copyright.CPRD study monitoring the use of valproate in girls and women in the UK: JANUARY 2010 to December 2019.2020. Available from:https:\/\/assets.publishing.service.gov.uk\/media\/5c17cc9f40f0b60bb17f6e79\/CPRD\u2010valproate\u2010usage\u201017122018.pdf"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2024.01.007"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.4897"},{"key":"e_1_2_13_7_1","first-page":"36","article-title":"Changes in sodium valproate dispensing in women of childbearing age with a diagnosis of borderline personality disorder in Aotearoa New Zealand","volume":"137","author":"Tennant M","year":"2024","journal-title":"N Z Med J"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-021-04351-x"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.p2836"},{"key":"e_1_2_13_10_1","unstructured":"The independent Medicines and Medical Devices Safety Review C. by B. C.First Do No Harm\u2010 The Report of the IMMDSReview.2020. 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