Abstract：
OBJECTIVE: This review aims to summarize existing evidence on the adverse pregnancy outcomes and seizure control effects of using lamotrigine (LTG) monotherapy in pregnancy women with epilepsy (WWE) during pregnancy.
METHODS: A comprehensive search was conducted in various databases including Cochrane, Web of Science, CBM, PubMed, Embase, CNKI, and Pregnancy Registration Center databases to identify relevant studies. The search was concluded up to January 2024. Studies comparing LTG with other antiseizure medications (ASMs) for treating epilepsy in pregnant women were included, with no language or regional restrictions.
RESULTS: A total of 19 studies were included for analysis, with 16 studies reporting adverse pregnancy outcomes and 6 studies reporting seizure control outcomes. Meta-analysis showed that compared to monotherapy with carbamazepine (CBZ), sodium valproate (VPA), and levetiracetam (LEV), LTG monotherapy had a slightly weaker ability to control seizures during pregnancy, with ORs and 95 %CIs of 0.65 (0.57-0.75; CBZ), 0.50 (0.32-0.79; VPA), and 0.55 (0.36-0.84; LEV). Regarding adverse pregnancy outcomes, the occurrence rate of LTG monotherapy was significantly lower than that of CBZ, VPA, phenytoin (PHT), and phenobarbital (PHB), with ORs and 95 %CIs ranging from 0.30 (0.25-0.35; VPA) to 0.68 (0.56-0.81; CBZ).
CONCLUSIONS: Based on meta-analysis, LTG and LEV appear to be preferred medications for controlling seizures during pregnancy. This review provides further support for the use of LTG monotherapy in pregnant WWE, building upon existing evidence for clinical practitioners.
METHODS: A comprehensive search was conducted in various databases including Cochrane, Web of Science, CBM, PubMed, Embase, CNKI, and Pregnancy Registration Center databases to identify relevant studies. The search was concluded up to January 2024. Studies comparing LTG with other antiseizure medications (ASMs) for treating epilepsy in pregnant women were included, with no language or regional restrictions.
RESULTS: A total of 19 studies were included for analysis, with 16 studies reporting adverse pregnancy outcomes and 6 studies reporting seizure control outcomes. Meta-analysis showed that compared to monotherapy with carbamazepine (CBZ), sodium valproate (VPA), and levetiracetam (LEV), LTG monotherapy had a slightly weaker ability to control seizures during pregnancy, with ORs and 95 %CIs of 0.65 (0.57-0.75; CBZ), 0.50 (0.32-0.79; VPA), and 0.55 (0.36-0.84; LEV). Regarding adverse pregnancy outcomes, the occurrence rate of LTG monotherapy was significantly lower than that of CBZ, VPA, phenytoin (PHT), and phenobarbital (PHB), with ORs and 95 %CIs ranging from 0.30 (0.25-0.35; VPA) to 0.68 (0.56-0.81; CBZ).
CONCLUSIONS: Based on meta-analysis, LTG and LEV appear to be preferred medications for controlling seizures during pregnancy. This review provides further support for the use of LTG monotherapy in pregnant WWE, building upon existing evidence for clinical practitioners.
摘要：
目的：本综述旨在总结现有的证据，证明拉莫三嗪（LTG）单药治疗妊娠合并癫痫（WWE）的妊娠妇女的不良妊娠结局和癫痫控制效果。
方法：在包括Cochrane在内的各种数据库中进行了全面搜索，WebofScience,CBM,PubMed,Embase,CNKI,和妊娠登记中心数据库来确定相关研究。搜索截止到2024年1月。包括比较LTG与其他抗癫痫药物（ASM）治疗孕妇癫痫的研究。没有语言或地区限制。
结果：共纳入19项研究进行分析，16项研究报告不良妊娠结局,6项研究报告癫痫控制结局.Meta分析显示，与卡马西平（CBZ）单药治疗相比，丙戊酸钠（VPA），和左乙拉西坦（LEV），LTG单药治疗在怀孕期间控制癫痫发作的能力稍弱，OR和95CI为0.65（0.57-0.75；CBZ），0.50(0.32-0.79;VPA),和0.55（0.36-0.84；LEV）。关于不良妊娠结局，LTG单药治疗的发生率明显低于CBZ，VPA,苯妥英(PHT),和苯巴比妥（PHB），OR和95CI的范围为0.30（0.25-0.35；VPA）至0.68（0.56-0.81；CBZ）。
结论：基于荟萃分析，LTG和LEV似乎是控制妊娠期癫痫发作的首选药物。这篇综述为LTG单药治疗在妊娠WWE中的应用提供了进一步的支持。建立在临床医生现有证据的基础上。
方法：在包括Cochrane在内的各种数据库中进行了全面搜索，WebofScience,CBM,PubMed,Embase,CNKI,和妊娠登记中心数据库来确定相关研究。搜索截止到2024年1月。包括比较LTG与其他抗癫痫药物（ASM）治疗孕妇癫痫的研究。没有语言或地区限制。
结果：共纳入19项研究进行分析，16项研究报告不良妊娠结局,6项研究报告癫痫控制结局.Meta分析显示，与卡马西平（CBZ）单药治疗相比，丙戊酸钠（VPA），和左乙拉西坦（LEV），LTG单药治疗在怀孕期间控制癫痫发作的能力稍弱，OR和95CI为0.65（0.57-0.75；CBZ），0.50(0.32-0.79;VPA),和0.55（0.36-0.84；LEV）。关于不良妊娠结局，LTG单药治疗的发生率明显低于CBZ，VPA,苯妥英(PHT),和苯巴比妥（PHB），OR和95CI的范围为0.30（0.25-0.35；VPA）至0.68（0.56-0.81；CBZ）。
结论：基于荟萃分析，LTG和LEV似乎是控制妊娠期癫痫发作的首选药物。这篇综述为LTG单药治疗在妊娠WWE中的应用提供了进一步的支持。建立在临床医生现有证据的基础上。
