Fetal Valproate Syndrome

Pediatr Neonatol. 2017 Apr;58(2):158-164. doi: 10.1016/j.pedneo.2016.01.009. Epub 2016 Jun 17.


Background: There have been several reports of congenital malformations in the offspring of mothers who took valproic acid (VPA) during pregnancy as a treatment for epilepsy.

Methods: Herein, we describe four cases with typically similar facial features of fetal valproate syndrome accompanied to minor skeletal abnormalities.

Results: The first case was a 16-month-old girl, presenting with facial dysmorphism, and finger abnormalities. Her mother took VPA (1500 mg/d) up to the 10th gestational week and at a dosage of 1000 mg/d through the pregnancy. The second patient was 5-year-old boy with speech disability, bilateral cryptorchidism, facial dysmorphism, and finger abnormalities whose mother took VPA (1000 mg/d) through pregnancy. The third 19-month-old patient was the brother of the second patient who had facial dysmorphism, bilateral cryptorchidism, and finger abnormalities. His mother also took VPA (1000 mg/d) through pregnancy. The fourth 3-year and 6 month-old boy with minor facial dysmorphism and sternum deformity was exposed to VPA (500 mg/d) in utero.

Conclusion: In conclusion, there is a recognizable spectrum of abnormalities in some infants exposed to VPA without dose-depence and the common facial dysmorphic features and minor skeletal abnormalities that may occur within the both low and high dose VPA use.

Keywords: facial dysmorphism; fetal valproate syndrome; minor birth defects; skeletal abnormalities.

Publication types

  • Case Reports

MeSH terms

  • Abnormalities, Drug-Induced / etiology*
  • Anticonvulsants / adverse effects*
  • Child, Preschool
  • Craniofacial Abnormalities / chemically induced
  • Cryptorchidism / chemically induced
  • Epilepsy / drug therapy
  • Female
  • Fingers / abnormalities
  • Humans
  • Infant
  • Male
  • Pregnancy
  • Pregnancy Complications / drug therapy
  • Sternum / abnormalities
  • Valproic Acid / adverse effects*


  • Anticonvulsants
  • Valproic Acid