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. 2023 Oct 24;2023(10):CD014967. doi: 10.1002/14651858.CD014967.pub2

Comparison 2. Phenobarbital versus levetiracetam as first‐line ASM in clinically diagnosed neonatal seizures.

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
2.1 Proportion of infants who achieve seizure control after the first loading dose of ASM 3 286 Risk Ratio (M‐H, Fixed, 95% CI) 0.69 [0.55, 0.86]
2.2 Proportion of infants who achieve seizure control after the maximal loading dose of ASM 3 260 Risk Ratio (M‐H, Fixed, 95% CI) 0.58 [0.47, 0.72]
2.3 Mortality before hospital discharge 6 452 Risk Ratio (M‐H, Fixed, 95% CI) 1.41 [0.82, 2.43]
2.4 Requirement for mechanical ventilation 5 394 Risk Ratio (M‐H, Fixed, 95% CI) 2.20 [0.50, 9.68]
2.5 Proportion of infants who develop sedation or drowsiness 2 180 Risk Ratio (M‐H, Fixed, 95% CI) 1.88 [0.66, 5.37]
2.6 Bradycardia 4 334 Risk Ratio (M‐H, Fixed, 95% CI) 6.00 [0.74, 48.97]
2.7 Hypotension requiring volume or inotropes 2 130 Risk Ratio (M‐H, Fixed, 95% CI) Not estimable
2.8 Shock requiring volume or inotropes 3 190 Risk Ratio (M‐H, Fixed, 99% CI) 0.67 [0.30, 1.51]
2.9 Proportion of infants with an abnormal background pattern in EEG during ASM treatment 1   Risk Ratio (M‐H, Fixed, 95% CI) Totals not selected
2.10 Proportion of infants with an abnormal background pattern in EEG after stopping ASM 1   Risk Ratio (M‐H, Fixed, 95% CI) Totals not selected
2.11 Duration of hospital stay 2 90 Mean Difference (IV, Fixed, 95% CI) 2.36 [0.54, 4.18]
2.12 Recurrence of seizure before hospital discharge 2 130 Risk Ratio (M‐H, Fixed, 95% CI) 1.67 [0.42, 6.60]
2.13 Proportion of infants with persistent seizures and/or requiring ASM at discharge 1   Risk Ratio (M‐H, Fixed, 95% CI) Totals not selected
2.14 Proportion of infants discharged on gavage feeds 2 130 Risk Ratio (M‐H, Fixed, 95% CI) Not estimable
2.15 Proportion of infants with an abnormal neurological examination at discharge 4 272 Risk Ratio (M‐H, Fixed, 95% CI) 0.80 [0.51, 1.24]
2.16 Proportion of infants who develop epilepsy post discharge 1   Risk Ratio (M‐H, Fixed, 95% CI) Totals not selected