TY - JOUR
T1 - First trimester exposure to topiramate and the risk of oral clefts in the offspring
T2 - A systematic review and meta-analysis
AU - Alsaad, Abdulaziz M.S.
AU - Chaudhry, Shahnaz Akthar
AU - Koren, Gideon
N1 - Publisher Copyright:
© 2015.
PY - 2015/6/1
Y1 - 2015/6/1
N2 - Topiramate (TPM) is an increasingly used drug during childbearing ages for treatment of epilepsy, migraine, and appetite suppression as well as for off-label indications such as sleep and psychiatric disorders. Presently, while some reports suggested an increased risk of oral cleft (OC), these reports are balanced by studies that could not confirm such association. We conducted a meta-analysis of all studies reporting on women exposed to TPM during pregnancy. Of the 2327 publications reviewed, 6 articles met the inclusion criteria including 3420 patients and 1,204,981 controls. The odd ratio (OR) of OC after the first trimester exposure to TPM exposure was 6.26 (95% confidence interval: 3.13-12.51; P= 0.00001). This study provides strong evidence that TPM is associated with an increased risk of OC in infants exposed to TPM during embryogenesis and should lead to a careful review of TPM use in women of reproductive ages.
AB - Topiramate (TPM) is an increasingly used drug during childbearing ages for treatment of epilepsy, migraine, and appetite suppression as well as for off-label indications such as sleep and psychiatric disorders. Presently, while some reports suggested an increased risk of oral cleft (OC), these reports are balanced by studies that could not confirm such association. We conducted a meta-analysis of all studies reporting on women exposed to TPM during pregnancy. Of the 2327 publications reviewed, 6 articles met the inclusion criteria including 3420 patients and 1,204,981 controls. The odd ratio (OR) of OC after the first trimester exposure to TPM exposure was 6.26 (95% confidence interval: 3.13-12.51; P= 0.00001). This study provides strong evidence that TPM is associated with an increased risk of OC in infants exposed to TPM during embryogenesis and should lead to a careful review of TPM use in women of reproductive ages.
KW - Epilepsy
KW - Infants
KW - Oral cleft
KW - Pregnancy
KW - Teratogenicity
KW - Topamax
KW - Topiramate
UR - http://www.scopus.com/inward/record.url?scp=84926019534&partnerID=8YFLogxK
U2 - 10.1016/j.reprotox.2015.03.003
DO - 10.1016/j.reprotox.2015.03.003
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C2 - 25797654
AN - SCOPUS:84926019534
SN - 0890-6238
VL - 53
SP - 45
EP - 50
JO - Reproductive Toxicology
JF - Reproductive Toxicology
ER -