期刊
ACTA NEUROLOGICA SCANDINAVICA
卷 130, 期 4, 页码 234-238出版社
WILEY
DOI: 10.1111/ane.12280
关键词
lamotrigine; levetiracetam; malformation; pregnancy; teratogenesis; topiramate
资金
- Epilepsy Society of Australia
- Victorian Epilepsy Foundation
- Royal Melbourne Hospital Neuroscience Foundation
- Epilepsy Australia
- NHMRC Linkage Grant
- Sanofi-Aventis
- UCB Pharma
- Janssen-Cilag
- Novartis
- Sci-Gen
ObjectiveTo assess the risk of teratogenicity from maternal intake of the more widely used newer antiepileptic drugs, especially lamotrigine, levetiracetam and topiramate. Materials and methodsUse of confidence interval and regression methods to compare risks of foetal malformation in pregnancies in women exposed (n=1572) and in women with epilepsy not exposed (n=153) to antiepileptic drugs in the first trimester. ResultsCompared with the foetal malformation rate in women with epilepsy who were untreated in the first trimester (3.3%), the malformation rates for lamotrigine (4.6%), levetiracetam (2.4%) and topiramate (2.4%), all in monotherapy, were not statistically significantly different. However, the malformation rates for topiramate as part of polytherapy (14.1%) and for valproate in both monotherapy (13.8%) and polytherapy (10.2%) were statistically significantly higher. Regression analysis of combined monotherapy and polytherapy data showed no statistically significant increased risk of teratogenesis associated with lamotrigine or levetiracetam, but a statistically significant and dose-related risk for first trimester topiramate (P=0.01) and valproate (P<0.0001) exposure. ConclusionsEvidence from this and other studies suggests that lamotrigine and levetiracetam have low risk for teratogenesis, but that topiramate exposure early in pregnancy may be associated with dose-related anatomical teratogenesis, as valproate is already known to be.
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