Valproic acid (VPA) is a recognized first-line agent for both focal and generalized seizures. Regrettably, as shown by comparisons with unexposed controls and children exposed to other antiseizure medications (ASMs), intrauterine exposure to VPA carries a 2- to 7-fold increased risk of major congenital malformations (MCMs) [1–3], with an average dose-dependent prevalence of approximately 10% [2,4]. It has also been associated with poorer cognitive development [5–8] and with significantly increased rates of autistic traits and autism [7,8].
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