Levetiracetam versus phenobarbital as first-line therapy for neonatal seizures: a comprehensive systematic review and meta-analysis with meta-regression of 26 studies involving 9,854 neonates

LEV and PB demonstrate comparable efficacy for first-line treatment of neonatal seizures; however, LEV provides a more favorable safety and tolerability profile, particularly with respect to cardiopulmonary stability. These findings support the consideration of LEV as an alternative first-line agent, especially in neonates at risk for hemodynamic or respiratory compromise. Further large, high-quality RCTs with standardized EEG confirmation and long-term neurodevelopmental follow-up are warranted.

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Publication Details

Journal
BMC Pediatrics
Published
2026-02-10
DOI
https://doi.org/10.1186/s12887-026-06539-6
Primary Topic
Neonatal and fetal brain pathology
Type
article
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article

Levetiracetam versus phenobarbital as first-line therapy for neonatal seizures: a comprehensive systematic review and meta-analysis with meta-regression of 26 studies involving 9,854 neonates

Mostafa Hossam El Din Moawad, Ibraheem M. Alkhawaldeh, Abdallah Alhusan, Abdelrahman M. Elettreby et al.
BMC Pediatrics
Neonatal and fetal brain pathology
article

Levetiracetam versus phenobarbital as first-line therapy for neonatal seizures: a comprehensive systematic review and meta-analysis with meta-regression of 26 studies involving 9,854 neonates

Mostafa Hossam El Din Moawad, Ibraheem M. Alkhawaldeh, Abdallah Alhusan, Abdelrahman M. Elettreby, Hamza A Abdul-Hafez, Malik Allahham, Ibrahim Serag, Omar Mohamed Helal, Ali Mohammad Asar Mohammad Ali, Youcef Chair, Mohamed Karawya, Hadeel Amin Al Kabi
article en

Abstract

LEV and PB demonstrate comparable efficacy for first-line treatment of neonatal seizures; however, LEV provides a more favorable safety and tolerability profile, particularly with respect to cardiopulmonary stability. These findings support the consideration of LEV as an alternative first-line agent, especially in neonates at risk for hemodynamic or respiratory compromise. Further large, high-quality RCTs with standardized EEG confirmation and long-term neurodevelopmental follow-up are warranted.

BMC PediatricsVol. 26(1)
Semmelweis University (HU), Suez Canal University (EG), University of Jordan (JO), Poznan University of Medical Sciences (PL), Suez University (EG), Jordan University of Science and Technology (JO), Mansoura University (EG), An-Najah National University (PS), Mutah University (JO), Alexandria University (EG)
Good health and well-being
Openalex Percentile: Top 60%
Neonatal and fetal brain pathology
DOIOpen Access PDFOpenAlex
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Levetiracetam versus phenobarbital as first-line therapy for neonatal seizures: a comprehensive systematic review and meta-analysis with meta-regression of 26 studies involving 9,854 neonates — Mostafa Hossam El Din Moawad, Ibraheem M. Alkhawaldeh, et al. · BMC Pediatrics (2026) | TGRS Research Map | TGRS