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Design: Population-based cohort study.
Setting: National register of children born in Denmark from 1996 to 2006.
Patients: 655 615 children with an estimated time of conception over 11 years to December 2006; 2644 children exposed to antiepileptic drugs during pregnancy and 508 exposed to valproate. Follow up to autism spectrum diagnosis; death; emigration; or until 31 December 2010. Excluded Those with likely errors or missing values for gestational age, adopted children, and death <1 year old.
Risk factors: Parental age at conception, parental psychiatric history, gestational age, birth weight, sex, congenital malformations and parity.
Outcomes: Absolute risk (cumulative incidence) and the HR of autism spectrum disorder and childhood autism in children after exposure to valproate in pregnancy.
Of 655 615, 5437 were identified with autism spectrum disorder, including 2067 with childhood autism. …
Competing interests None.
Provenance and peer review Commissioned; internally peer reviewed.