{"title":"母亲暴露于拉莫三嗪和子代口面部裂的风险:一项系统回顾和荟萃分析","authors":"Ze-lin Zhao , Xiao-ming Jin , Fang-ping Shi, Qiao-qun Dai, Yin Wu, Zhao-jie Zheng","doi":"10.1016/j.seizure.2025.06.005","DOIUrl":null,"url":null,"abstract":"<div><div>Lamotrigine is used to treat epilepsy, migraine, and psychiatric disorders during pregnancy. However, concerns remain regarding whether lamotrigine exposure increases the risk of orofacial clefts (OFCs) in offspring. A systematic literature search was conducted to identify relevant studies published from inception to February 2025. Random-effects models were used to estimate the overall relative risk. Eight observational studies were included in the analysis. The overall results indicated that maternal lamotrigine exposure during pregnancy was associated with a significantly increased risk of OFCs in offspring (odds ratio [OR] = 1.42, 95 % confidence interval [CI] = 1.05–1.92, <em>P</em> < 0.001, I<sup>2</sup> = 39.8 %). However, this association disappeared when data were pooled from cohort studies (OR = 1.4, 95 % CI = 0.67–2.9, <em>P</em> = 0.37) or from studies adjusting for at least five variables (OR = 0.97, 95 % CI = 0.63–1.48, <em>P</em> = 0.871, I<sup>2</sup> = 0.0 %). Our findings suggest that <em>in utero</em> exposure to lamotrigine does not increase the risk of OFCs in offspring.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"131 ","pages":"Pages 67-72"},"PeriodicalIF":2.7000,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Maternal exposure to lamotrigine and the risk of orofacial clefts in offspring: A systematic review and meta-analysis\",\"authors\":\"Ze-lin Zhao , Xiao-ming Jin , Fang-ping Shi, Qiao-qun Dai, Yin Wu, Zhao-jie Zheng\",\"doi\":\"10.1016/j.seizure.2025.06.005\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><div>Lamotrigine is used to treat epilepsy, migraine, and psychiatric disorders during pregnancy. However, concerns remain regarding whether lamotrigine exposure increases the risk of orofacial clefts (OFCs) in offspring. A systematic literature search was conducted to identify relevant studies published from inception to February 2025. Random-effects models were used to estimate the overall relative risk. Eight observational studies were included in the analysis. The overall results indicated that maternal lamotrigine exposure during pregnancy was associated with a significantly increased risk of OFCs in offspring (odds ratio [OR] = 1.42, 95 % confidence interval [CI] = 1.05–1.92, <em>P</em> < 0.001, I<sup>2</sup> = 39.8 %). However, this association disappeared when data were pooled from cohort studies (OR = 1.4, 95 % CI = 0.67–2.9, <em>P</em> = 0.37) or from studies adjusting for at least five variables (OR = 0.97, 95 % CI = 0.63–1.48, <em>P</em> = 0.871, I<sup>2</sup> = 0.0 %). Our findings suggest that <em>in utero</em> exposure to lamotrigine does not increase the risk of OFCs in offspring.</div></div>\",\"PeriodicalId\":49552,\"journal\":{\"name\":\"Seizure-European Journal of Epilepsy\",\"volume\":\"131 \",\"pages\":\"Pages 67-72\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-06-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Seizure-European Journal of Epilepsy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1059131125001517\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Seizure-European Journal of Epilepsy","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1059131125001517","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
拉莫三嗪用于治疗妊娠期间的癫痫、偏头痛和精神疾病。然而,关于拉莫三嗪暴露是否会增加后代患口面部裂(OFCs)的风险,人们仍然存在担忧。我们进行了系统的文献检索,以确定从成立到2025年2月发表的相关研究。随机效应模型用于估计总体相对风险。8项观察性研究被纳入分析。总体结果表明,妊娠期间母体拉莫三嗪暴露与后代OFCs风险显著增加相关(优势比[OR] = 1.42, 95%可信区间[CI] = 1.05-1.92, P <;0.001, i2 = 39.8%)。然而,当从队列研究(OR = 1.4, 95% CI = 0.67-2.9, P = 0.37)或从至少调整了5个变量的研究(OR = 0.97, 95% CI = 0.63-1.48, P = 0.871, I2 = 0.0%)汇总数据时,这种关联消失了。我们的研究结果表明,子宫内暴露于拉莫三嗪不会增加后代患OFCs的风险。
Maternal exposure to lamotrigine and the risk of orofacial clefts in offspring: A systematic review and meta-analysis
Lamotrigine is used to treat epilepsy, migraine, and psychiatric disorders during pregnancy. However, concerns remain regarding whether lamotrigine exposure increases the risk of orofacial clefts (OFCs) in offspring. A systematic literature search was conducted to identify relevant studies published from inception to February 2025. Random-effects models were used to estimate the overall relative risk. Eight observational studies were included in the analysis. The overall results indicated that maternal lamotrigine exposure during pregnancy was associated with a significantly increased risk of OFCs in offspring (odds ratio [OR] = 1.42, 95 % confidence interval [CI] = 1.05–1.92, P < 0.001, I2 = 39.8 %). However, this association disappeared when data were pooled from cohort studies (OR = 1.4, 95 % CI = 0.67–2.9, P = 0.37) or from studies adjusting for at least five variables (OR = 0.97, 95 % CI = 0.63–1.48, P = 0.871, I2 = 0.0 %). Our findings suggest that in utero exposure to lamotrigine does not increase the risk of OFCs in offspring.
期刊介绍:
Seizure - European Journal of Epilepsy is an international journal owned by Epilepsy Action (the largest member led epilepsy organisation in the UK). It provides a forum for papers on all topics related to epilepsy and seizure disorders.