Pregnancy
Men taking valproate advise to use effective contraception in case of harm to children
Men taking valproate and their partners are being advised by the UK Medicines and Healthcare products Regulatory Agency (MHRA) to use effective contraception because of new data suggesting a potential small increased risk of harm to children if used by a father at conception.
This precautionary advice follows the analysis of a retrospective observational study which reports a possible association between valproate use by men and a small increased risk of a range of neurodevelopmental disorders in their children (aged 0 to 11 years) when compared to men prescribed lamotrigine or levetiracetam.
The study, carried out in some of the Scandinavian countries where valproate is used, showed that around five out of 100 children had a neurodevelopmental disorder when born to fathers treated with valproate compared with around three out of 100 when born to fathers treated with lamotrigine or levetiracetam.
Whilst this study does not prove that valproate use in men increased the risk of problems in children, it is an important safety issue that warrants action on a precautionary basis.
Though the risk is much lower than the risk of neurodevelopmental disorders in children born to mothers who take valproate during pregnancy, the MHRA advice, which has been introduced as a precautionary measure, recommends that male patients and their partner use effective contraception during valproate treatment and for at least three months after stopping valproate.
Patients should not donate sperm during treatment with valproate and for three months after stopping valproate.
Healthcare professionals should inform male patients about this newly identified risk at their next routine treatment review, offer them a discussion about how it impacts their current treatment and other potential treatment options available. For those patients wishing to change their treatment the MHRA recommends that priority be given to male patients who are planning to father a child in the next year.
The MHRA has encouraged patients to attend their next routine appointment to discuss their treatment plan and to talk to a healthcare professional if they have any questions.
No one should stop taking valproate without advice from a specialist because of the importance of keeping their condition under control.
Anyone with questions should speak to a healthcare professional. Any suspected side effects associated with valproate should be reported via the Yellow Card scheme.
A second pregnancy alters the female brain in ways distinct from a first, according to research examining how motherhood affects brain structure and function.
The study tracked 110 women using repeated brain scans. Some became mothers for the first time, others had a second child, while a third group remained childless, allowing researchers to identify pregnancy-related brain changes.
During a first pregnancy, the greatest changes occurred in the default mode network, a brain system involved in self-reflection and social processes. During a second pregnancy, this network changed again, but less strongly.
Instead, a second pregnancy was associated with more changes in brain networks linked to directing attention and responding to stimuli, functions that may be useful when caring for more than one child.
Each pregnancy produced both shared and distinct effects on the brain, with patterns differing between first and second pregnancies.
Elseline Hoekzema, head of the Pregnancy Brain Lab at Amsterdam UMC, said: “With this, we have shown for the first time that the brain not only changes during the first pregnancy, but also during a second. During a first and second pregnancy, the brain changes in both similar and unique ways. Each pregnancy leaves a unique mark on the female brain.”
Milou Straathof, a researcher who analysed the data, said: “It appears that during a second pregnancy, the brain is more strongly altered in networks involved in reacting to sensory cues and in controlling your attention. These processes may be beneficial when caring for multiple children.”
The researchers also found a link between brain changes and the bond between mother and child, which was more pronounced during a first pregnancy than a second. They also observed associations between structural brain changes and peripartum depression, a form of depression that can occur during pregnancy or after birth, in both first and second pregnancies.
This provides the first evidence that changes in the cortex, the brain’s outer layer, during pregnancy are linked to maternal depression.
For women who became mothers for the first time, this link was especially visible after childbirth. For women having their second child, it was particularly apparent during pregnancy.
The researchers said: “This knowledge can help to better understand and recognise mental health problems in mothers. It is important that we understand how the brain adapts to motherhood.
They added that the findings could support better care for mothers, including the prevention and treatment of postnatal depression. Although most women experience pregnancy once or multiple times, scientists are only beginning to understand how it affects the brain.
Matresa has raised £315k in pre-seed funding to build a maternal health platform offering personalised screening and support in the UK.
The funding comes as maternal deaths in the UK are at their highest level in more than 20 years, according to the company.
Founded by former nurse Mari-Carmen Sanchez-Morris, Matresa is developing a platform that combines clinical expertise, behavioural science and AI insights to support women through matrescence, the transition from pregnancy into early parenthood.
Sanchez-Morris launched the company after working in a paediatric intensive care unit, where she saw gaps in support for mothers before and after birth.
Sanchez-Morris said: “Poor maternal healthcare isn’t just happening in a vacuum: it affects other areas of healthcare, and stunts women’s career growth, which in turn impacts businesses and the wider economy.
“Tailored care isn’t a privilege – it’s a right. Women and mothers deserve to feel safe and supported, and we need to do more to tackle this crisis.”
One in five women experience maternal mental health disorders or serious complications after childbirth, according to the company.
It says earlier intervention could prevent many of these outcomes, yet gaps in services persist. Preventable maternal health issues are estimated to cost the economy between £13bn and £15bn a year.
The platform also targets employers by offering visibility and insight during maternity leave. Currently, one in three mothers leave the workforce within a year of childbirth, with replacement costs for skilled employees ranging from £30k to £150k.
The pre-seed round was led by SFC Capital.
Edward Stevenson, fund principal at SFC Capital, said: “SFC Capital was delighted to lead this investment round in Matresa.
“We made this investment given the talent and strength of Mari-Carmen and the growing problem that the company is solving. She has demonstrated to us tenacity and determination in all our interactions, all of which suggest to us that she is 100 per cent committed to improving maternal health for women everywhere.”
Matresa is set to launch this summer.
Nighttime temperatures during pregnancy may be linked to a higher chance of an autism diagnosis in children, a recent study suggests.
The research tracked nearly 295,000 mother-child pairs in Southern California from 2001 to 2014 and linked warmer overnight temperatures with higher risk in early and late pregnancy.
Children of mothers exposed to higher than typical nighttime temperatures during weeks one to 10 of pregnancy had a 15 per cent higher risk of an autism diagnosis.
Exposure during weeks 30 to 37 was linked to a 13 per cent higher risk.
Lead author David Luglio, a post-doctoral fellow at Tulane University, said: “A key takeaway is that we identified specific windows when a mother and her developing child can be most affected by exposures to higher nighttime temperatures.
“This is critical and hopefully can help mothers prepare accordingly.”
The study is described as the first to examine how temperature may affect fetal neurodevelopment, the process by which a baby’s brain and nervous system form during pregnancy.
Extreme temperatures linked to increased risk were classified as above the 90th percentile, meaning 3.6°F hotter than average, and the 99th percentile, 5.6°F above average.
The association held even after researchers accounted for factors such as neighbourhood conditions, vegetation and fine-particle air pollution.
The study could not account for other factors such as access to air conditioning. Researchers did not find the same association with daytime temperatures, potentially because people spend more time away from home during the day.
“Heat waves are becoming more frequent, and people may only think of the dangers of daytime heat exposure,” said Mostafijur Rahman, assistant professor of environmental health sciences at Tulane University.
“These results indicate a strong association between high nighttime temperatures during pregnancy and autism risk in children and show that we need to think about exposure to heat around the clock.”
The study did not examine how higher temperatures at night might affect prenatal development, though Luglio said it is possible that warmer nights disrupt sleep for pregnant mothers.
Previous research has suggested insufficient sleep during pregnancy may be linked to a higher risk of neurocognitive delays in children.
“Extreme heat exposure during pregnancy has been linked to a range of adverse health outcomes, including prenatal neurodevelopment delays and complications with an embryo’s development of a central nervous system,” Luglio said.
“The goal of our study was to specifically explore the link between prenatal heat exposure and autism diagnoses for the first time.”
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