Evidence map›Paper›PMID 38308208›Full record

SynthesisBMC pregnancy and childbirth2024

Neurodevelopmental outcomes after prenatal exposure to lamotrigine monotherapy in women with epilepsy: a systematic review and meta-analysis.

Audrey Peron, Cyndie Picot, Lucie Jurek, Mikaïl Nourredine, Emmanuelle Ripoche, Priscilla Ajiji, Michel Cucherat, Judith Cottin

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in BMC pregnancy and childbirth, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
15.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Observational
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 6 institutions in 1 country.

Audrey PeronService Hospitalo-Universitaire de Pharmacotoxicologie de Lyon, Hospices Civils de Lyon, Bât. A-162, avenue Lacassagne, Lyon Cedex 03, 69424, France.
Cyndie PicotService Hospitalo-Universitaire de Pharmacotoxicologie de Lyon, Hospices Civils de Lyon, Bât. A-162, avenue Lacassagne, Lyon Cedex 03, 69424, France.
Lucie JurekPôle de psychiatrie de l'Enfant et l'Adolescent, Centre Hospitalier Le Vinatier, Bron, France.
Mikaïl NourredineService Hospitalo-Universitaire de Pharmacotoxicologie de Lyon, Hospices Civils de Lyon, Bât. A-162, avenue Lacassagne, Lyon Cedex 03, 69424, France.
Emmanuelle RipocheAdverse Events and Incidents Department-Surveillance Division, Agence nationale de sécurité du médicament et des produits de santé (ANSM), Saint Denis, France.
Priscilla AjijiAdverse Events and Incidents Department-Surveillance Division, Agence nationale de sécurité du médicament et des produits de santé (ANSM), Saint Denis, France.
Michel CucheratService Hospitalo-Universitaire de Pharmacotoxicologie de Lyon, Hospices Civils de Lyon, Bât. A-162, avenue Lacassagne, Lyon Cedex 03, 69424, France.
Judith CottinService Hospitalo-Universitaire de Pharmacotoxicologie de Lyon, Hospices Civils de Lyon, Bât. A-162, avenue Lacassagne, Lyon Cedex 03, 69424, France. judith.cottin@chu-lyon.fr.
Agence Nationale de Sécurité du Médicament et des Produits de Santé · FRHospices Civils de Lyon · FRCentre Hospitalier Le Vinatier · FRHôpital Lyon Sud · FRUniversité Claude Bernard Lyon 1 · FRUniversité de Bretagne Occidentale · FR

Funding

Agence Nationale de Sécurité du Médicament et des Produits de Santé 69HCL20_0005_1
6 · The paper itself

Abstract

backgroundLamotrigine has become one of the most commonly prescribed antiseizure medications (ASM) in epileptic women during pregnancy and therefore requires regular updates regarding its safety. The aim of this study was to estimate the association between in utero exposure to lamotrigine monotherapy and the occurrence of neurodevelopmental outcomes.

methodsAll comparative studies assessing the occurrence of neurodevelopmental outcomes after epilepsy-indicated lamotrigine monotherapy exposure during pregnancy were searched. First, references were identified through a snowballing approach, then, through electronic databases (Medline and Embase) from 2015 to June 2022. One investigator evaluated study eligibility and extracted data and a second independent investigator reviewed the meta-analysis (MA). A systematic review and random-effects model approach were performed using a collaborative WEB-based meta-analysis platform (metaPreg.org) with a registered protocol (osf.io/u4gva).

resultsOverall, 18 studies were included. For outcomes reported by at least 4 studies, the pooled odds ratios and 95% confidence interval obtained with the number of exposed (N1) and unexposed children (N0) included were: neurodevelopmental disorders as a whole 0.84 [0.66;1.06] (N1 = 5,271; N0 = 22,230); language disorders or delay 1.16 [0.67;2.00] (N1 = 313; N0 = 506); diagnosis or risk of ASD 0.97 [0.61;1.53] (N1 = at least 5,262; N0 = 33,313); diagnosis or risk of ADHD 1.14 [0.75;1.72] (N1 = at least 113; N0 = 11,530) and psychomotor developmental disorders or delay 2.68 [1.29-5.56] (N1 = 163; N0 = 220). The MA of cognitive outcomes included less than 4 studies and retrieved a significant association for infants exposed to lamotrigine younger than 3 years old but not in the older age groups.

conclusionPrenatal exposure to lamotrigine monotherapy is not found to be statistically associated with neurodevelopmental disorders as a whole, language disorders or delay, diagnosis or risk of ASD and diagnosis or risk of ADHD. However, the MA found an increased risk of psychomotor developmental disorders or delay and cognitive developmental delay in less than 3 years old children. Nevertheless, these findings were based exclusively on observational studies presenting biases and on a limited number of included children. More studies should assess neurodevelopmental outcomes in children prenatally exposed to lamotrigine.

Indexed as

EpilepsyLanguage DisordersPrenatal Exposure Delayed EffectsAgedAnticonvulsantsChildChild, PreschoolFemaleHumansInfantLamotriginePregnancyVitaminsAnticonvulsantsLamotrigineVitaminsEpilepsyLamotrigineMeta-analysisNeurodevelopmental disordersPregnancySystematic review

Identifiers

PMID38308208
PMCPMC10835851
OpenAlexW4391474149

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.