Drugs commonly prescribed to control epileptic seizures as well as symptoms associated with bipolar disorder, pain, and migraine headaches have been linked to an increased risk of birth defects when taken by women who are in the early stages of pregnancy, according to a new study published in the journal Neurology.

The study reviewed data from 8,794 women who had been prescribed an anti-epileptic drug. About 10.4% of the women were prescribed valproic acid, and researchers found they were 19 times more likely to have a baby with spina bifida compared to women who did not take anti-convulsant medication. Valporic acid also increased the risk of seven other birth defects including cleft palate and four different heart defects.

About 5.9% of the women were treated with topiramate. They were seven times more likely to have a baby with a cleft lip (with or without cleft palate) compared to women who were not taking epilepsy drugs.

The anti-epilepsy drugs lamotrigine, levetiracetam, carbamazepine, oxcarbazepine and gabapentin were not associated with an increased risk of birth defects, but researchers noted a possible risk of microcephaly (small head circumference) in women taking clonazepam, and an increased risk of heart defects were associated with phenobarbital and pregabalin, though the data was not statistically significant, researchers said.

“We’ve been concerned about valproic acid for many years,” Dr. David Flicker, chairman-elect of the Epilepsy Foundation told CNN, adding that the study “confirms other large-scale studies where similar findings were found.”

The news is concerning, considering about 21.9 of every 1,000 expectant mothers in the United States takes an anti-epileptic drug for various reasons. That’s about three times more than expectant mothers in France and about five times more than pregnant women in the Netherlands, according to previous research cited by the authors.

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