In a recent statement entitled, "Valproic Acid: Benefits and Risks" we reported that despite the presence of teratogenic effects in animals there existed only one possible case in man.1 Recently the Centers for Disease Control has reported that the use of valproic acid (Depakene), during the first trimester of pregnancy, may increase the risk of having a child with spina bifids.2 The report, based upon a study undertaken in Rhône-Alpes, France,3,4 quotes an estimated risk of 1.2%. Based upon this information, we believe that a woman who becomes pregnant while on valproic acid should consult with her physician about prenatal testing for neural tube defects. Additional recommendations for the counseling of women who require anticounvulsant treatment during pregnancy have been published previously.5