MALFORMATIONS, WITHDRAWAL MANIFESTATIONS, AND HYPOGLYCEMIA AFTER EXPOSURE TO VALPROATE IN-UTERO

An unselected series is presented of 17 infants born to epileptic moth ers and exposed to sodium valproate during pregnancy. Nine infants had minor abnormalities and of these infants five also had major malforma tions, described as the 'fetal valproate syndrome'. The most frequent malformation was congenital heart disease. Nine of the infants had man ifestations of withdrawal, such as irritability, jitteriness, abnormal ities of tone, seizures, and feeding problems. Four of these infants h ad an unrelated hypoglycaemia. The frequency of withdrawal symptoms wa s significantly related to the dose of valproate given to the mothers in the third trimester, and there was a tendency for both the frequenc y of the minor abnormalities and the major malformations to be related to the valproate dosage in the first trimester.