Alsfouk BA. Neurodevelopmental outcomes in children exposed prenatally to levetiracetam.
Ther Adv Drug Saf 2022;
13:20420986221088419. [PMID:
35387387 PMCID:
PMC8977694 DOI:
10.1177/20420986221088419]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 03/02/2022] [Indexed: 11/15/2022] Open
Abstract
Some old antiseizure medications (ASMs) pose teratogenic risks, including major
congenital malformations and neurodevelopmental delay. Therefore, the use of new
ASMs in pregnancy is increasing, particularly lamotrigine and levetiracetam.
This is likely due to evidence of low risk of anatomical teratogenicity for both
lamotrigine and levetiracetam. Regarding neurodevelopmental effects, lamotrigine
is the most frequently investigated new ASM with information available for
children up to 14 years of age. However, fewer data are available for the
effects of levetiracetam on cognitive and behavioral development, with smaller
cohorts and shorter follow-up. The aim of the present review was to explicate
neurodevelopmental outcomes in children exposed prenatally to levetiracetam to
support clinical decision-making. The available data do not indicate an
increased risk of abnormal neurodevelopmental outcomes in children exposed
prenatally to levetiracetam. Findings demonstrated comparable outcomes for
levetiracetam versus controls and favorable outcomes for
levetiracetam versus valproate on global and specific cognitive
abilities, and behavioral problems. In addition, the available evidence shows no
significant dose-effect association for levetiracetam on neurodevelopmental
outcomes. However, this evidence cannot be determined definitively due to the
limited numbers of exposures with relatively short follow-up. Therefore, further
research is required.
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