癫痫杂志

癫痫杂志

妊娠期左乙拉西坦对新生儿安全性的 Meta 分析

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目的通过系统性文献回顾分析新型抗癫痫药物左乙拉西坦(LEV)在妊娠期使用对新生儿的安全性影响。方法文献检索范围为英文文献,发表时间 1997 年–2018 年。Meta 分析采用随机效果法。结果搜索到相关文献 118 篇,有 7 篇文献符合分析标准,共 672 例使用 LEV 的病例组和 772 234 例对照组被选入进行 Meta 分析。LEV 组和对照组新生儿不良率差异无统计学意义[OR=1.05,95% CI(0.54,2.02),P=0.37]。进一步行 LEV 单药治疗和其他药物联合治疗对新生儿安全性的评价,共有 464 例单药治疗组和 632 例多药治疗组被选入进行 Meta 分析。结果显示,单药组和多药组新生儿不良率差异无统计学意义[OR=0.54,95%CI(0.31,0.96),P=0.32]。结论综合检索到的临床研究,妊娠期 LEV 单药治疗对于新生儿是安全的,LEV 和多药联合治疗也未见明显不良反应。

ObjectivesUsing systematic literature review to analyze the effects of levetiracetam (LEV) on neonatal safety during early pregnancy.MethodsThe scope of the literature must be English literature, published from 1997 to 2018. Meta-analysis was performed by random effects models.ResultsSeven literatures were included. A total of 672 cases exposed to LEV in treatment group and 772 234 cases in control groups were selected for meta-analysis. There was no significant difference in neonatal malignancy between treatment group and control group[OR=1.05, 95% CI (0.54, 2.02), P=0.37]. Further, we evaluated the effect of LEV monotherapy and polytherapy on neonatal safety, a total of 464 monotherapy cases and 632 polytherapy cases respectively were selected for meta-analysis. The results showed that there was no significant difference between these two therapies in neonatal malignancy [OR=0.54, 95% CI(0.31, 0.96), P=0.32].ConclusionsAs the papers we included, levetiracetam in the treatment of epilepsy during pregnancy is relatively safe for newborn.

关键词: 左乙拉西坦; 抗癫痫药; 妊娠期; 新生儿; 安全性; Meta 分析

Key words: Levetiracetam; Anti-epileptic drug; Pregancy; Newborn; Safety; Meta analysis

引用本文: 汤莹莹. 妊娠期左乙拉西坦对新生儿安全性的 Meta 分析. 癫痫杂志, 2018, 4(5): 387-390. doi: 10.7507/2096-0247.20180063 复制

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1. WHO/Epilepsy. http://www.who.int/mental_health/neurology/epilepsy/en/.
2. GBD 2015 Neurological Disorders Collaborator Group. Global, regional, and national burden of neurological disorders during 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Neurol, 2017, 16(11): 877-897.
3. Loscher W, Klitgaard H, Twyman RE, et al. New avenues for anti-epileptic drug discovery and development. Nat Rev Drug Discov, 2013, 12(10): 757-776.
4. Veiby G, Daltveit AK, Engelsen BA, et al. Fetal growth restriction and birth defects with newer and olderantiepileptic drugs during pregnancy. J Neurol, 2014, 261(3): 579-588.
5. Morrow J, Russell A, Guthrie E, et al. Malformation risks of antiepileptic drugs in pregnancy: a prospective study from the UK epilepsyand pregnancy register. J Neurol Neurosurg Psychiatry, 2006, 77(2): 193-198.
6. Weston J, Bromley R, Jackson CF, et al. Monotherapy treatment of epilepsy in pregnancy: congenitalmalformation outcomes in the child. Cochrane Database of Sys Rev, 2016, 11: CD010224.
7. Hunt S, Craig J, Russell A, et al. Levetiracetam inpregnancy: Preliminary experience from the UK epilepsy and pregnancy register. Neurology, 2006, 67(10): 1876-1879.
8. Longo B, Forinash AB, Murphy JA. Levetiracetam use in pregnancy. Ann Pharmacother, 2009, 43(10): 1692-1695.
9. Mawhinney E, Craig J, Morrow J, et al. Levetiracetam in pregnancy: results from the UK and ireland epilepsy and pregnancy registers. Neurology, 2013, 80(4): 400-405.
10. Vajda FJ, O’Brien TJ, Lander CM, et al. The teratogenicity of the newer antiepileptic drugs-an update. Acta Neurol Scand, 2014, 130(4): 234-238.