Table 5. Sibling Analyses of the Association of Prenatal Valproate Exposure With Childhood Epilepsya.
| ASM exposure | Sibling sets of mothers with epilepsy | Incidence rate, per 10 000 person-years (95% CI) | AHR (95% CI) | ||
|---|---|---|---|---|---|
| Total No. (N = 13 886) | With epilepsy, No. | Unadjusted | Adjustedb | ||
| Sibling sets of mothers using valproate in at least 1 pregnancy and no ASM in at least 1 other | 258 | NA | NA | NA | NA |
| Pregnancies with no ASM use | 374 | 16 | 44.0 (27.0-71.9) | 1 [Reference] | 1 [Reference] |
| Pregnancies with valproate use | 312 | 16 | 47.3 (29.0-77.3) | 0.59 (0.24-1.42) | 0.58 (0.23-1.46) |
| Sibling sets of mothers using valproate in at least 1 pregnancy and no valproate in at least 1 other | 418 | NA | NA | NA | NA |
| Pregnancies with no valproate use | 604 | 23 | 40.9 (27.2-61.6) | 1 [Reference] | 1 [Reference] |
| Pregnancies with valproate use | 529 | 31 | 54.2 (38.1-77.1) | 1.08 (0.57-2.04) | 0.95 (0.50-1.82) |
Abbreviations: AHR, adjusted hazard ratio; ASM, antiseizure medication; NA, not applicable.
a
Based on 5 Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden) from 1996 to 2017.
b
Adjusted for sex of the child, maternal age, parity, smoking in pregnancy, and use of antidepressants in pregnancy.