Carbamazepine (Epilepsy) updated on 04-22-2025

Psychomotor developmental disorders/delay

R analysis
id Study   Lib. in paper Exposition period    Study type 
 Control type 
 
Tags OR 95%CI x1/n1 x0/n0 no cases no exposed ROB Ref.
S19434
R82813		 Honybun (Controls exposed to LTG) (Carbamazepine) (Epilepsy), 2026 Processing Speed Index (Assesses psychomotor speed across time-based tasks) - Wechsler Intelligence Scale - Children aged 3–18 years (mean age about 10 years) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No extrapolated (cont. endpoint) 3.13 [1.02;9.54]
excluded (control group) 		-/20   -/23 - 20
ref
S19438
R82853		 Honybun (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026 Processing Speed Index (Assesses psychomotor speed across time-based tasks) - Wechsler Intelligence Scale - Children aged 3–18 years (mean age about 10 years) during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No extrapolated (cont. endpoint) 4.38 [1.33;14.40] -/20   -/19 - 20
ref
S19457
R82942		 Straub (Controls exposed to LTG) (Carbamazepine) (Epilepsy), 2026 Coordination disorders - ICD-10 codes: F82 - Mean follow up (full cohort): 3.4 years during pregnancy (anytime or not specified) retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: No 1.13 [0.61;2.08] C
excluded (control group) 		16/1,548   30/3,273 46 1,548
ref
S19467
R83018		 Straub (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026 Coordination disorders - ICD-10 codes: F82 - Mean follow up (full cohort): 3.4 years during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, sick Adjustment: Yes 1.17 [0.66;2.09] 16/1,548   91/8,887 107 1,548
ref
S15365
R63217		 Bromley (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2023 Motor mean score ≤ 86 (below average performance of the cohort mean) - Bayley Scales of Infant and Toddler Development - At 24 months of age during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No 0.99 [0.19;5.18] C
excluded (control group) 		2/21   7/73 9 21
ref
S15366
R63230		 Bromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Motor mean score ≤ 86 (below average performance of the cohort mean) - Bayley Scales of Infant and Toddler Development - At 24 months of age during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No 1.16 [0.20;6.87] C 2/21   4/48 6 21
ref
S16780
R70450		 Thomas b (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2022 Delayed motor development quotient (< 84, i.e one SD of the mean) - The developmental assessment scale for Indian infants (DASII) - Between 12-24 months of age (mean (SD): 15.3 (3.9) months)) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No 5.60 [0.74;42.16] C
excluded (control group) 		58/317   1/26 59 317
ref
S16781
R70451		 Thomas b (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2022 The motor development quotient (MODQ) - The developmental assessment scale for Indian infants (DASII) - Between 12-24 months of age (mean (SD): 15.3 (3.9) months)) during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No extrapolated (cont. endpoint) 1.10 [0.74;1.64] -/317   -/110 - 317
ref
S8042
R24926		 Deshmukh (Carbamazepine), 2016 Vineland-II Adaptative Behavior Scales - Low and moderately low in the motor skills domain throughout pregnancy prospective cohort exposed to other treatment, sick Adjustment: Yes 0.81 [0.19;3.41] 8/97   8/104 16 97
ref
S9938
R35719		 Videman (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2016 Griffiths Mental Developmental Scale - Locomotor (at the age of 7 months) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No extrapolated (cont. endpoint) 0.20 [0.03;1.27]
excluded (control group) 		-/9   -/8 - 9
ref
S9935
R35701		 Videman (Carbamazepine) (Controls unexposed, disease free), 2016 Griffiths Mental Developmental Scale - Locomotor (at the age of 7 months) during pregnancy (anytime or not specified) prospective cohort unexposed, disease free Adjustment: No extrapolated (cont. endpoint) 2.37 [0.66;8.52] -/9   -/59 - 9
ref
S6661
R18417		 Bromley (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013 Dyspraxia (at 6 years old) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No 0.19 [0.01;4.87] C
excluded (control group) 		0/50   1/30 1 50
ref
S6660
R18413		 Bromley (Carbamazepine) (Controls unexposed, disease free), 2013 Dyspraxia (at 6 years old) during pregnancy (anytime or not specified) prospective cohort unexposed, disease free excluded Adjustment: No 4.31 [0.08;220.05] C
excluded (control group) 		0/50   0/214 0 50
ref
S5486
R18102		 Bromley (Carbamazepine) (Controls unexposed, sick), 2013 Dyspraxia (at 6 years old) during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No 0.52 [0.01;26.73] C 0/50   0/26 0 50
ref
S6420
R17632		 Cohen (Carbamazepine), 2011 Motor Index score (the Bayley Scales of Infant Development (BSID-II)) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick Adjustment: Yes extrapolated (cont. endpoint) 0.87 [0.45;1.71] -/51   -/62 - 51
ref
S5831
R14430		 Viinikainen (Carbamazepine) b, 2006 Touwen's test Neurological dysfunction/impairment throughout pregnancy prospective cohort unexposed, sick Adjustment: No 0.46 [0.04;5.79] C 1/13   2/13 3 13
ref
S5541
R16582		 Adab (Carbamazepine), 2004 Schedule of Growing Skills II (SGSII) locomotion delay during pregnancy (anytime or not specified) retrospective cohort unexposed, sick Adjustment: No 0.42 [0.01;22.11] C 0/42   0/18 0 42
ref
S5559
R20855		 Ornoy (Carbamazepine), 1996 Combined motor score (of Bayley and McCarthy tests) throughout pregnancy prospective cohort unexposed (general population or NOS) Adjustment: No extrapolated (cont. endpoint) Matched 0.97 [0.45;2.07] -/41   -/47 - 41
ref
Total 11 studies 1.14 [0.88;1.46] 132 2,209
x1: number of endpoints among exposed, n1: number of exposed; x0: number of endpoints among non exposed, n0: number of non exposed; C: calculated odds ratio from numbers of events and effectives

Forest plot

StudyTE95% CIn casesn exposedweightROBABCDEF Honybun (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026Honybun, 2026 1 4.38[1.33; 14.40]-204%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: criticalROB mesure: lowROB reporting: moderate Straub (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026Straub, 2026 2 1.17[0.66; 2.09]1071,54819%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: unclearROB mesure: criticalROB reporting: moderate Bromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023Bromley, 2023 3 1.16[0.20; 6.87]6212%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: moderateROB mesure: lowROB reporting: low Thomas b (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2022Thomas b, 2022 4 1.10[0.74; 1.64]-31740%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: unclearROB mesure: lowROB reporting: moderate Deshmukh (Carbamazepine), 2016Deshmukh, 2016 5 0.81[0.19; 3.41]16973%ROB confusion: moderateROB selection: lowROB classification: moderateROB missing: criticalROB mesure: moderateROB reporting: moderate Videman (Carbamazepine) (Controls unexposed, disease free), 2016Videman, 2016 6 2.37[0.66; 8.52]-94%ROB confusion: unclearROB selection: lowROB classification: moderateROB missing: criticalROB mesure: lowROB reporting: moderate Bromley (Carbamazepine) (Controls unexposed, sick), 2013Bromley, 2013 7 0.52[0.01; 26.73]0500%ROB confusion: criticalROB selection: lowROB classification: lowROB missing: moderateROB mesure: moderateROB reporting: moderate Cohen (Carbamazepine), 2011Cohen, 2011 8 0.87[0.45; 1.71]-5114%ROB confusion: moderateROB selection: lowROB classification: lowROB missing: criticalROB mesure: lowROB reporting: moderate Viinikainen (Carbamazepine) b, 2006Viinikainen, 2006 9 0.46[0.04; 5.79]3131%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: moderateROB mesure: lowROB reporting: moderate Adab (Carbamazepine), 2004Adab, 2004 10 0.42[0.01; 22.11]0420%ROB confusion: criticalROB selection: criticalROB classification: lowROB missing: criticalROB mesure: lowROB reporting: moderate Ornoy (Carbamazepine), 1996Ornoy, 1996 11 0.97[0.45; 2.07]-4111%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Total (11 studies) I2 = 0% 1.14[0.88; 1.46]1322,2090.210.01.0ROB: A: confounding, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, sick) (Carbamazepine) (Epilepsy; 2: Controls unexposed, sick) (Carbamazepine) (Epilepsy; 3: Carbamazepine) (Epilepsy) (Controls unexposed, sick; 4: Carbamazepine) (Epilepsy) (Controls unexposed, sick; 5: Carbamazepine; 6: Carbamazepine) (Controls unexposed, disease free; 7: Carbamazepine) (Controls unexposed, sick; 8: Carbamazepine; 9: Carbamazepine) ; 10: Carbamazepine; 11: Carbamazepine;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.14[0.88; 1.46]1322,2090%NAHonybun (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026 Straub (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026 Bromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Thomas b (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2022 Deshmukh (Carbamazepine), 2016 Videman (Carbamazepine) (Controls unexposed, disease free), 2016 Bromley (Carbamazepine) (Controls unexposed, sick), 2013 Cohen (Carbamazepine), 2011 Viinikainen (Carbamazepine) b, 2006 Adab (Carbamazepine), 2004 Ornoy (Carbamazepine), 1996 11 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.30[0.57; 2.96]-5028%NAVideman (Carbamazepine) (Controls unexposed, disease free), 2016 Ornoy (Carbamazepine), 1996 2 unexposed, sickunexposed, sick 1.20[0.88; 1.63]1162,0110%NAHonybun (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026 Straub (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026 Bromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Thomas b (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2022 Bromley (Carbamazepine) (Controls unexposed, sick), 2013 Viinikainen (Carbamazepine) b, 2006 Adab (Carbamazepine), 2004 7 exposed to other treatment, sickexposed to other treatment, sick 0.86[0.47; 1.57]161480%NADeshmukh (Carbamazepine), 2016 Cohen (Carbamazepine), 2011 2 Tags Adjustment   - No  - No 1.22[0.88; 1.70]95131%NAHonybun (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026 Bromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Thomas b (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2022 Videman (Carbamazepine) (Controls unexposed, disease free), 2016 Bromley (Carbamazepine) (Controls unexposed, sick), 2013 Viinikainen (Carbamazepine) b, 2006 Adab (Carbamazepine), 2004 Ornoy (Carbamazepine), 1996 8   - Yes  - Yes 1.01[0.67; 1.53]1231,6960%NAStraub (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026 Deshmukh (Carbamazepine), 2016 Cohen (Carbamazepine), 2011 3 extrapolated (cont. endpoint)extrapolated (cont. endpoint) 1.27[0.81; 1.99]-43843%NAHonybun (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026 Thomas b (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2022 Videman (Carbamazepine) (Controls unexposed, disease free), 2016 Cohen (Carbamazepine), 2011 Ornoy (Carbamazepine), 1996 5 MatchedMatched 0.97[0.45; 2.08]-41 -NAOrnoy (Carbamazepine), 1996 1 All studiesAll studies 1.14[0.88; 1.46]1322,2090%NAHonybun (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026 Straub (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026 Bromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Thomas b (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2022 Deshmukh (Carbamazepine), 2016 Videman (Carbamazepine) (Controls unexposed, disease free), 2016 Bromley (Carbamazepine) (Controls unexposed, sick), 2013 Cohen (Carbamazepine), 2011 Viinikainen (Carbamazepine) b, 2006 Adab (Carbamazepine), 2004 Ornoy (Carbamazepine), 1996 110.210.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-4.84.92.4240.000Honybun (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026Straub (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026Bromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023Thomas b (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2022Deshmukh (Carbamazepine), 2016Videman (Carbamazepine) (Controls unexposed, disease free), 2016Bromley (Carbamazepine) (Controls unexposed, sick), 2013Cohen (Carbamazepine), 2011Viinikainen (Carbamazepine) b, 2006Adab (Carbamazepine), 2004Ornoy (Carbamazepine), 1996

Asymetry test p-value = 0.9691 (by Egger's regression)

slope=0.1207 (0.2163); intercept=0.0202 (0.5062); t=0.0399; p=0.9691

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 6661, 6660, 9938, 16780, 15365, 19434, 19457

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.27[0.66; 2.42]-1000%NAVideman (Carbamazepine) (Controls unexposed, disease free), 2016 Bromley (Carbamazepine) (Controls unexposed, disease free), 2013 Ornoy (Carbamazepine), 1996 3 unexposed, sick controlsunexposed, sick controls 1.20[0.88; 1.63]1162,0110%NAHonybun (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026 Straub (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026 Bromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Thomas b (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2022 Bromley (Carbamazepine) (Controls unexposed, sick), 2013 Viinikainen (Carbamazepine) b, 2006 Adab (Carbamazepine), 2004 7 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.10[0.64; 1.88]1312,11335%NAHonybun (Controls exposed to LTG) (Carbamazepine) (Epilepsy), 2026 Straub (Controls exposed to LTG) (Carbamazepine) (Epilepsy), 2026 Bromley (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2023 Thomas b (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2022 Deshmukh (Carbamazepine), 2016 Videman (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2016 Bromley (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013 Cohen (Carbamazepine), 2011 80.510.01.0