{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:35:04Z","timestamp":1777944904897,"version":"3.51.4"},"reference-count":42,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100025520","name":"Medical Research Future Fund","doi-asserted-by":"publisher","award":["ARGCHDG000041"],"award-info":[{"award-number":["ARGCHDG000041"]}],"id":[{"id":"10.13039\/501100025520","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Womens Health (Lond Engl)"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Awareness of the risks of prescribing valproate to girls and women of childbearing potential has increased, with some countries strongly restricting prescribing and requiring pregnancy prevention plans.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To explore changes in valproate dispensing patterns and the proportion of women covered by prescription contraceptives, especially long-acting forms, in Australia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Population-based cohort study using routinely collected government data on dispensed medications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We analysed a 10% random sample of Australian Pharmaceutical Benefits Scheme (PBS) dispensing data for women aged 15\u201349\u2009years. We calculated the annual rate of initiating valproate and alternative anti-seizure medications. We assessed what proportion of women were covered by long-acting or other PBS prescription contraception at treatment commencement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Between 2013 and 2021, overall valproate initiation declined substantially (from 2.06 to 0.75 per 1000 women per annum), compensated by a rise in the initiation of alternative anti-seizure medications. This reflected a decline in valproate initiated as a first-line treatment, with valproate initiated as a second-line treatment remaining stable. For women initiating valproate, contraception coverage by an intrauterine device or implant increased from 16% in 2013 to 22% in 2021. In 2021, no coverage by PBS prescription contraceptives occurred in 69% of women initiating valproate and 68% of women initiating alternative anti-seizure medications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>A decline in valproate prescribing has occurred in Australia. At the time treatment commenced, the great majority of women dispensed valproate were not covered by any form of PBS prescription contraceptive, which is of concern.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17455057251414916","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T07:00:53Z","timestamp":1771311653000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Longitudinal Australian trends in the initiation of valproate medication among women of reproductive age and concurrent use of prescription contraceptives"],"prefix":"10.1177","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6302-3697","authenticated-orcid":false,"given":"Mumtaz","family":"Begum","sequence":"first","affiliation":[{"name":"Robinson Research Institute, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia"},{"name":"Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lynne","family":"Giles","sequence":"additional","affiliation":[{"name":"Robinson Research Institute, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia"},{"name":"School of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenni","family":"Ilomaki","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice","family":"Rumbold","sequence":"additional","affiliation":[{"name":"Robinson Research Institute, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia"},{"name":"South Australian Health and Medical Research Institute, Women and Kids, South Australian Health and Medical Research Institute, Adelaide, SA, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Davies","sequence":"additional","affiliation":[{"name":"Robinson Research Institute, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia"},{"name":"Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luke E","family":"Grzeskowiak","sequence":"additional","affiliation":[{"name":"Robinson Research Institute, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia"},{"name":"Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia"},{"name":"South Australian Health and Medical Research Institute, Women and Kids, South Australian Health and Medical Research Institute, Adelaide, SA, Australia"},{"name":"College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vivienne","family":"Moore","sequence":"additional","affiliation":[{"name":"Robinson Research Institute, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia"},{"name":"School of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,2,16]]},"reference":[{"key":"e_1_3_3_2_2","volume-title":"Advisory Committee on Medicines. 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Valproate: review of safety data and expert advice on management of risks Public Assessment Report November 2023 www.gov.uk\/mhra (2023)."},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/HRP.0000000000000292"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/20451253221110016"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-021-04351-x"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11096-025-01915-1"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30495-2"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30107-8"},{"key":"e_1_3_3_11_2","volume-title":"Public Assessment Report of antiepileptic drugs: review of safety of use during pregnancy","author":"Medicine and Health Care Products Regulatory Authority-UK Government","year":"2021","unstructured":"Medicine and Health Care Products Regulatory Authority-UK Government. Public Assessment Report of antiepileptic drugs: review of safety of use during pregnancy. MHRA Public Assessment Report. January 2021."},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2004.05.003"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.2270"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2022.1269"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2022-074630"},{"key":"e_1_3_3_16_2","volume-title":"Valproate anti-seizure products contraindicated for migraine prevention in pregnant women due to decreased IQ scores in exposed children","author":"FDA Drug Safety Communication","year":"2013","unstructured":"FDA Drug Safety Communication. Valproate anti-seizure products contraindicated for migraine prevention in pregnant women due to decreased IQ scores in exposed children. FDA, 2013."},{"key":"e_1_3_3_17_2","unstructured":"European Medicines Agency. Assessment report. Procedure under Article 31 of Directive 2001\/83\/EC resulting from pharmacovigilance data http:\/\/www.ema.europa.eu\/docs\/en_GB\/document_library\/Referrals_document\/Valproate_and_related_substances_31\/Recommendation_provided_by_Pharmacovigilance_Risk_Assessment_Committee\/WC500177352.pdf (2014)."},{"key":"e_1_3_3_18_2","volume-title":"New measures to avoid valproate exposure in pregnancy endorsed Member State representatives agree new restrictions and pregnancy prevention programme","author":"European Medicines Agency","year":"2018","unstructured":"European Medicines Agency. New measures to avoid valproate exposure in pregnancy endorsed Member State representatives agree new restrictions and pregnancy prevention programme. European Medicines Agency, 2018."},{"key":"e_1_3_3_19_2","article-title":"France\u2019s drug regulator is indicted for manslaughter over sodium valproate birth defects","volume":"371","author":"Dyer O.","year":"2020","unstructured":"Dyer O. 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