Does lamotrigine use in pregnancy increase orofacial cleft risk relative to other malformations?

Details

Serval ID
serval:BIB_2FDDD905C5CC
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Does lamotrigine use in pregnancy increase orofacial cleft risk relative to other malformations?
Journal
Neurology
Author(s)
Dolk H., Jentink J., Loane M., Morris J., de Jong-van den Berg L.T.
Working group(s)
EUROCAT Antiepileptic Drug Working Group
Contributor(s)
Calzolari E., Barisic I., Wellesley D., Garne E., De Vigan C., de Walle H., Bakker M., Gatt M., Melve KK., O'Mahony M., Nelen V., Gillerot Y., Rivieri F., Pierini A., Queisser-Luft A., Poetzsch S., Tucker D., Portillo I., Latos-Bielenska A., Mejnartowicz J., Doray B., Addor MC.
ISSN
1526-632X (Electronic)
ISSN-L
0028-3878
Publication state
Published
Issued date
2008
Volume
71
Number
10
Pages
714-722
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't Publication Status: ppublish
Abstract
OBJECTIVE: To investigate whether first trimester exposure to lamotrigine (LTG) monotherapy is specifically associated with an increased risk of orofacial clefts (OCs) relative to other malformations, in response to a signal regarding increased OC risk.
METHODS: Population-based case-control study with malformed controls based on EUROCAT congenital anomaly registers. The study population covered 3.9 million births from 19 registries 1995-2005. Registrations included congenital anomaly among livebirths, stillbirths, and terminations of pregnancy following prenatal diagnosis. Cases were 5,511 nonsyndromic OC registrations, of whom 4,571 were isolated, 1,969 were cleft palate (CP), and 1,532 were isolated CP. Controls were 80,052 nonchromosomal, non-OC registrations. We compared first trimester LTG and antiepileptic drug (AED) use vs nonepileptic non-AED use, for mono and polytherapy, adjusting for maternal age. An additional exploratory analysis compared the observed and expected distribution of malformation types associated with LTG use.
RESULTS: There were 72 LTG exposed (40 mono- and 32 polytherapy) registrations. The ORs for LTG monotherapy vs no AED use were 0.67 (95% CI 0.10-2.34) for OC relative to other malformations, 0.80 (95% CI 0.11-2.85) for isolated OC, 0.79 (95% CI 0.03-4.35) for CP, and 1.01 (95% CI 0.03-5.57) for isolated CP. ORs for any AED use vs no AED use were 1.43 (95% CI 1.03-1.93) for OC, 1.21 (95% CI 0.82-1.72) for isolated OC, 2.37 (95% CI 1.54-3.43) for CP, and 1.86 (95% CI 1.07-2.94) for isolated CP. The distribution of other nonchromosomal malformation types with LTG exposure was similar to non-AED exposed.
CONCLUSION: We find no evidence of a specific increased risk of isolated orofacial clefts relative to other malformations due to lamotrigine (LTG) monotherapy. Our study is not designed to assess whether there is a generalized increased risk of malformations with LTG exposure.
Keywords
Adolescent, Antimanic Agents/adverse effects, Case-Control Studies, Child, Child, Preschool, Cleft Lip/chemically induced, Cleft Lip/epidemiology, Community Health Planning, Confidence Intervals, Congenital Abnormalities/epidemiology, Congenital Abnormalities/etiology, Epilepsy/drug therapy, Female, Humans, Male, Odds Ratio, Pregnancy, Pregnancy Complications/chemically induced, Prenatal Exposure Delayed Effects, Registries, Retrospective Studies, Risk, Risk Factors, Triazines/adverse effects
Pubmed
Web of science
Create date
31/03/2009 10:18
Last modification date
20/08/2019 13:14
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