Carbamazepine (Epilepsy) updated on 04-22-2025

Learning disorders

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
R82817		 Honybun (Controls exposed to LTG) (Carbamazepine) (Epilepsy), 2026 Academic Outcomes: Word reading - Wide Range Achievement Test–Fifth Edition - 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) 1.23 [0.35;4.29]
excluded (control group) 		-/14   -/19 - 14
ref
S19438
R82859		 Honybun (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026 Academic Outcomes: Sentence comprehension - Wide Range Achievement Test–Fifth Edition - 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) 6.37 [1.46;27.69] -/14   -/13 - 14
ref
S19457
R82944		 Straub (Controls exposed to LTG) (Carbamazepine) (Epilepsy), 2026 Learning difficulty - ICD-10 codes: F81.0, F81.2, F81.8x, R48.0 - 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 2.30 [1.05;5.06] C
excluded (control group) 		13/1,548   12/3,273 25 1,548
ref
S19467
R83020		 Straub (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026 Learning difficulty - ICD-10 codes: F81.0, F81.2, F81.8x, R48.0 - Mean follow up (full cohort): 3.4 years during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, sick Adjustment: Yes 0.96 [0.49;1.89] 13/1,548   43/8,887 56 1,548
ref
S15369
R63261		 Ren (Carbamazepine) (Epilepsy), 2023 Mathematics at 9th grade - Mean age 16.1 (SD 0.4) years during pregnancy (anytime or not specified) population based cohort propective unexposed, sick Adjustment: Yes extrapolated (cont. endpoint) 1.22 [0.98;1.52] -/226   -/3,167 - 226
ref
S8252
R26068		 Forsberg (Carbamazepine) (Controls unexposed NOS), 2011 School grades: Mathematics - not passed (at 16 years) during pregnancy (anytime or not specified) retrospective cohort (registry) unexposed (general population or NOS) excluded Adjustment: No 1.60 [0.99;2.56]
excluded (control group) 		31/160   200,988/1,188,726 201,019 160
ref
S9968
R35831		 Forsberg (Carbamazepine) (Controls unexposed, sick), 2011 School grades: Sports - not passed (at 16 years) during pregnancy (anytime or not specified) retrospective cohort (registry) unexposed, sick Adjustment: No 0.93 [0.51;1.70] C 24/157   26/160 50 157
ref
S6823
R19283		 Van der Pol (Carbamazepine) (Controls unexposed, disease free), 1991 Poor arithmetic (Dutch test) throughout pregnancy prospective cohort unexposed, disease free excluded Adjustment: No Matched 0.92 [0.04;21.20] C
excluded (control group) 		0/8   2/37 2 8
ref
S6825
R19333		 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 Poor arithmetic (Dutch test) throughout pregnancy prospective cohort unexposed, sick Adjustment: No 0.51 [0.02;14.28] C 0/8   1/13 1 8
ref
Total 5 studies 1.19 [0.81;1.74] 107 1,953
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 6.37[1.46; 27.69]-146%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: criticalROB mesure: lowROB reporting: moderate Straub (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026Straub, 2026 2 0.96[0.49; 1.89]561,54821%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: unclearROB mesure: criticalROB reporting: moderate Ren (Carbamazepine) (Epilepsy), 2023Ren, 2023 3 1.22[0.98; 1.52]-22649%ROB confusion: seriousROB selection: moderateROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Forsberg (Carbamazepine) (Controls unexposed, sick), 2011Forsberg, 2011 4 0.93[0.51; 1.70]5015724%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991Van der Pol, 1991 5 0.51[0.02; 14.28]181%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: criticalROB mesure: moderateROB reporting: moderate Total (5 studies) I2 = 37% 1.19[0.81; 1.74]1071,9530.220.01.0ROB: 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; 4: Carbamazepine) (Controls unexposed, sick; 5: Carbamazepine) (Controls unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.19[0.81; 1.74]1071,95337%NAHonybun (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026 Straub (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026 Ren (Carbamazepine) (Epilepsy), 2023 Forsberg (Carbamazepine) (Controls unexposed, sick), 2011 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 5 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 1.19[0.81; 1.74]1071,95337%NAHonybun (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026 Straub (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026 Ren (Carbamazepine) (Epilepsy), 2023 Forsberg (Carbamazepine) (Controls unexposed, sick), 2011 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 5 Tags Adjustment   - No  - No 1.69[0.38; 7.51]5117966%NAHonybun (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026 Forsberg (Carbamazepine) (Controls unexposed, sick), 2011 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 3   - Yes  - Yes 1.19[0.97; 1.47]561,7740%NAStraub (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026 Ren (Carbamazepine) (Epilepsy), 2023 2 extrapolated (cont. endpoint)extrapolated (cont. endpoint) 2.36[0.48; 11.53]-24079%NAHonybun (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026 Ren (Carbamazepine) (Epilepsy), 2023 2 All studiesAll studies 1.19[0.81; 1.74]1071,95337%NAHonybun (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026 Straub (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026 Ren (Carbamazepine) (Epilepsy), 2023 Forsberg (Carbamazepine) (Controls unexposed, sick), 2011 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 50.220.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-4.04.22.0390.000Honybun (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026Straub (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026Ren (Carbamazepine) (Epilepsy), 2023Forsberg (Carbamazepine) (Controls unexposed, sick), 2011Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991

Asymetry test p-value = 0.8300 (by Egger's regression)

slope=0.1378 (0.2192); intercept=0.2304 (0.9844); t=0.2340; p=0.8300

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 6823, 8252, 19434, 19457

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.58[0.99; 2.53]201,0211680%NAForsberg (Carbamazepine) (Controls unexposed NOS), 2011 Van der Pol (Carbamazepine) (Controls unexposed, disease free), 1991 2 unexposed, sick controlsunexposed, sick controls 1.19[0.81; 1.74]1071,95337%NAHonybun (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026 Straub (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026 Ren (Carbamazepine) (Epilepsy), 2023 Forsberg (Carbamazepine) (Controls unexposed, sick), 2011 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 5 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.93[0.99; 3.75]251,5620%NAHonybun (Controls exposed to LTG) (Carbamazepine) (Epilepsy), 2026 Straub (Controls exposed to LTG) (Carbamazepine) (Epilepsy), 2026 20.510.01.0

Umbrella review (other published meta-analyses)

Published MAControlPeriodTE95% CIn exposedkI2 Karain (Epilepsy) (Educational outcomes (Spec ...Karain (Epilepsy) (Educational outcomes (Special educational needs, Learning difficulties/classroom support, School-related behaviour, Academic performance)) 1.28[0.70; 2.32]64%-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT4 metaPregmetaPreg 1.19[0.81; 1.74]37%1,953----Honybun (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026 Straub (Controls unexposed, sick) (Carbamazepine) (Epilepsy), 2026 Ren (Carbamazepine) (Epilepsy), 2023 Forsberg (Carbamazepine) (Controls unexposed, sick), 2011 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 50.510.01.0