Carbamazepine (Epilepsy) - Medication and Pregnancy KB

Carbamazepine (Epilepsy) updated on 04-22-2025

Cognitive developmental disorders/delay (> 6 years old)

R analysis

id	Study	Lib. in paper	Exposition period	Study type All studies Case control excluded Only case control	Control type	Tags	OR 95%CI	x1/n1 x0/n0	no cases	no exposed	ROB	Ref.
S17426 R73199	Madley-Dowd_SE (Carbamazepine) (Controls exposed to LTG), 2024	Intellectual disability (intelligence quotient below 70) - ICD-8/9/10 codes - Mean 5-20 years old (according groups°	during pregnancy (anytime or not specified)	population based cohort retrospective	exposed to other treatment, sick excluded	Adjustment: No Partial overlapping	2.17 [1.41;3.33] ^C excluded (control group)	56/1,842 34/2,383	90	1,842		ref
S17427 R73200	Madley-Dowd_SE (Carbamazepine) (Controls unexposed, sick), 2024	Intellectual disability (intelligence quotient below 70) - ICD-8/9/10 codes - Mean 5-20 years old (according groups)	during pregnancy (anytime or not specified)	population based cohort retrospective	unexposed, sick	Adjustment: Yes Partial overlapping	1.44 [1.06;1.97]	56/1,842 194/10,769	250	1,842		ref
S17107 R72240	Madley-Dowd_UK (Carbamazepine) (Controls unexposed, sick), 2024	Intellectual disability - ICD10 codes - Median CBZ 9.17 (5.31-12.54) years old	during pregnancy (anytime or not specified)	retrospective cohort (claims database)	unexposed, sick	Adjustment: Yes	1.75 [0.47;6.59]	-/460 13/4,075	-	460		ref
S16768 R70429	Stjerna (Carbamazepine) (Epilepsy), 2024	Full scale intelligence quotient (FSIQ continuous) - The Wechsler Intelligence Scale for Children (WISC-III) - At 6-7 years old	throughout pregnancy	retrospective cohort	exposed to other treatment, sick	Adjustment: Yes extrapolated (cont. endpoint)	0.95 [0.46;1.96]	-/36 -/74	-	36		ref
S15868 R65363	Dreier (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2023	Intellectual disability - Corresponding ICD-10 F-chapter - Up to 22 years of age	during pregnancy (anytime or not specified)	population based cohort propective	exposed to other treatment, sick excluded	Adjustment: No	2.12 [1.32;3.39] ^C excluded (control group)	36/2,665 34/5,288	70	2,665		ref
S15869 R65379	Dreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023	Intellectual disability - Corresponding ICD-10 F-chapter - Up to 22 years of age	during pregnancy (anytime or not specified)	population based cohort propective	unexposed, sick	Adjustment: Yes	1.11 [0.73;1.70]	36/2,665 184/22,203	220	2,665		ref
S12896 R53292	Adams (Carbamazepine), 2022	Full Scale IQ - The Wechsler Intelligence Scale for Children, 3rd Edition (WISC-III) (mean >6 years old)	during pregnancy (anytime or not specified)	retrospective cohort	unexposed, sick	Adjustment: No extrapolated (cont. endpoint) Matched	2.98 [1.33;6.66]	-/41 -/41	-	41		ref
S15377 R63353	Thomas a (Carbamazepine), 2022	Full-scale IQ - Wechsler Intelligence Scale for Children or Adult - Ages 13 to 21 years (mean of 16.5 ± 2.2 years)	during pregnancy (anytime or not specified)	prospective cohort	unexposed, sick	Adjustment: No extrapolated (cont. endpoint)	1.85 [0.55;6.31]	-/38 -/11	-	38		ref
S8324 R53293	Baker (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2015	Mean child Full scale IQ - Differential ability scales (DAS) (age mean >6 years old)	during pregnancy (anytime or not specified)	prospective cohort	exposed to other treatment, sick excluded	Adjustment: No extrapolated (cont. endpoint)	0.77 [0.34;1.77] excluded (control group)	-/50 -/29	-	50		ref
S8254 R53294	Baker (Carbamazepine) (Controls unexposed, disease free), 2015	IQ <85 - Differential ability scales (DAS) (age mean >6 years old)	during pregnancy (anytime or not specified)	prospective cohort	unexposed, disease free excluded	Adjustment: Yes	3.50 [1.10;10.20] excluded (control group)	-/50 -/210	-	50		ref
S8326 R53295	Baker (Carbamazepine) (Controls unexposed, sick), 2015	Mean child Full scale IQ - Differential ability scales (DAS) (age mean >6 years old)	during pregnancy (anytime or not specified)	prospective cohort	unexposed, sick	Adjustment: No extrapolated (cont. endpoint)	0.88 [0.37;2.11]	-/50 -/25	-	50		ref
S386 R53299	Meador (Carbamazepine), 2013	IQ <85 (DAS) (at 6 years old)	during pregnancy (anytime or not specified)	prospective cohort	exposed to other treatment, sick	Adjustment: Yes	3.21 [0.60;17.19] ^C	5/61 2/74	7	61		ref
S6188 R53300	Nadebaum (Carbamazepine), 2011	Full-scale child's IQ (Wechsler Intelligence Scale for Children (WISC))	during pregnancy (anytime or not specified)	prospective cohort	exposed to other treatment, sick	Adjustment: No extrapolated (cont. endpoint)	1.82 [0.48;6.95]	-/34 -/9	-	34		ref
S6106 R53305	Titze (Carbamazepine) (Controls unexposed, disease free), 2008	Learning disability (IQ<70) (German versions of the revised Wechsler Intelligence Scales for children and for adults)	during pregnancy (anytime or not specified)	prospective cohort	unexposed, disease free excluded	Adjustment: No Matched	13.86 [0.24;809.27] ^C excluded (control group)	0/4 0/49	0	4		ref
S6112 R53306	Titze (Carbamazepine) (Controls unexposed, sick), 2008	Learning disability (IQ<70) (German versions of the revised Wechsler Intelligence Scales for children and for adults)	during pregnancy (anytime or not specified)	prospective cohort	unexposed, sick	Adjustment: No	1.10 [0.04;33.38] ^C	0/4 1/13	1	4		ref
S5831 R53301	Viinikainen (Carbamazepine) b, 2006	Full Scale IQ (FIQ) < 1SD Wechsler Intelligence Scale for Children (WISC III)	throughout pregnancy	prospective cohort	unexposed, sick	Adjustment: No	5.95 [0.26;138.26] ^C	2/13 0/13	2	13		ref
S5560 R53307	Vinten (Carbamazepine), 2005	IQ score <69 Wechsler Intelligence Scale for Children (WISC III) (Aged between 6 and 16 years)	during pregnancy (anytime or not specified)	retrospective cohort	unexposed, sick	Adjustment: No	1.03 [0.28;3.83] ^C	4/52 6/80	10	52		ref
S5541 R53291	Adab (Carbamazepine), 2004	Mean Full Scale IQ Wechsler Intelligence Scale for Children (WISC) (Aged between 6 and 16 years)	during pregnancy (anytime or not specified)	retrospective cohort	unexposed, sick	Adjustment: No extrapolated (cont. endpoint)	0.85 [0.45;1.60]	-/52 -/80	-	52		ref
S7236 R53296	Gaily (Carbamazepine) (Controls unexposed, disease free), 2004	Full scale IQ (Wechsler Preschool and Primary Scale of Intelligence Revised (WPPSI-R) or Wechsler Intelligence Scale for Children Revised (WISC-R))	2nd and/or 3rd trimester	prospective cohort	unexposed, disease free excluded	Adjustment: No extrapolated (cont. endpoint)	0.80 [0.49;1.30] excluded (control group)	-/86 -/140	-	86		ref
S5557 R53297	Gaily (Carbamazepine) (Controls unexposed, sick), 2004	Full scale IQ (Wechsler Preschool and Primary Scale of Intelligence Revised (WPPSI-R) or Wechsler Intelligence Scale for Children Revised (WISC-R))	2nd and/or 3rd trimester	prospective cohort	unexposed, sick	Adjustment: No extrapolated (cont. endpoint)	0.65 [0.34;1.26]	-/86 -/45	-	86		ref
					Total	14 studies	1.22 [0.98;1.53]		490	5,434
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

1: Carbamazepine) (Controls unexposed, sick; 2: Carbamazepine) (Controls unexposed, sick; 3: Carbamazepine) (Epilepsy; 4: Carbamazepine) (Epilepsy) (Controls unexposed, sick; 5: Carbamazepine; 6: Carbamazepine; 7: Carbamazepine) (Controls unexposed, sick; 8: Carbamazepine; 9: Carbamazepine; 10: Carbamazepine) (Controls unexposed, sick; 11: Carbamazepine) ; 12: Carbamazepine; 13: Carbamazepine; 14: Carbamazepine) (Controls unexposed, sick;

Sensitivity analysis

Publication bias and p-hacking diagnosis

funnel plot

Asymetry test p-value = 0.5194 (by Egger's regression)

slope=0.1052 (0.1939); intercept=0.3600 (0.5424); t=0.6638; p=0.5194

p values plot

Sub-groups analysis using all included studies

excluded 7236, 6106, 8324, 8254, 15868, 17426

S17426 R73199	Madley-Dowd_SE (Carbamazepine) (Controls exposed to LTG), 2024	Intellectual disability (intelligence quotient below 70) - ICD-8/9/10 codes - Mean 5-20 years old (according groups° (318)	during pregnancy (anytime or not specified)	exposed to other treatment, sick	2.17 [1.41;3.33]	56/1842 34/2383
S17427 R73200	Madley-Dowd_SE (Carbamazepine) (Controls unexposed, sick), 2024	Intellectual disability (intelligence quotient below 70) - ICD-8/9/10 codes - Mean 5-20 years old (according groups) (318)	during pregnancy (anytime or not specified)	unexposed, sick	1.44 [1.06;1.97]	56/1842 194/10769
S17107 R72240	Madley-Dowd_UK (Carbamazepine) (Controls unexposed, sick), 2024	Intellectual disability - ICD10 codes - Median CBZ 9.17 (5.31-12.54) years old (318)	during pregnancy (anytime or not specified)	unexposed, sick	1.75 [0.47;6.59]	-9/460 13/4075
S16768 R70429	Stjerna (Carbamazepine) (Epilepsy), 2024	Full scale intelligence quotient (FSIQ continuous) - The Wechsler Intelligence Scale for Children (WISC-III) - At 6-7 years old (318)	throughout pregnancy	exposed to other treatment, sick	0.95 [0.46;1.96]	-9/36 -9/74
S15868 R65363	Dreier (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2023	Intellectual disability - Corresponding ICD-10 F-chapter - Up to 22 years of age (318)	during pregnancy (anytime or not specified)	exposed to other treatment, sick	2.12 [1.32;3.39]	36/2665 34/5288
S15869 R65379	Dreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023	Intellectual disability - Corresponding ICD-10 F-chapter - Up to 22 years of age (318)	during pregnancy (anytime or not specified)	unexposed, sick	1.11 [0.73;1.70]	36/2665 184/22203
S12896 R53292	Adams (Carbamazepine), 2022	Full Scale IQ - The Wechsler Intelligence Scale for Children, 3rd Edition (WISC-III) (mean >6 years old) (318)	during pregnancy (anytime or not specified)	unexposed, sick	2.98 [1.33;6.66]	-9/41 -9/41
S15377 R63353	Thomas a (Carbamazepine), 2022	Full-scale IQ - Wechsler Intelligence Scale for Children or Adult - Ages 13 to 21 years (mean of 16.5 ± 2.2 years) (318)	during pregnancy (anytime or not specified)	unexposed, sick	1.85 [0.55;6.31]	-9/38 -9/11
S8324 R53293	Baker (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2015	Mean child Full scale IQ - Differential ability scales (DAS) (age mean >6 years old) (318)	during pregnancy (anytime or not specified)	exposed to other treatment, sick	0.77 [0.34;1.77]	-9/50 -9/29
S8254 R53294	Baker (Carbamazepine) (Controls unexposed, disease free), 2015	IQ <85 - Differential ability scales (DAS) (age mean >6 years old) (318)	during pregnancy (anytime or not specified)	unexposed, disease free	3.50 [1.10;10.20]	-9/50 -9/210
S8326 R53295	Baker (Carbamazepine) (Controls unexposed, sick), 2015	Mean child Full scale IQ - Differential ability scales (DAS) (age mean >6 years old) (318)	during pregnancy (anytime or not specified)	unexposed, sick	0.88 [0.37;2.11]	-9/50 -9/25
S386 R53299	Meador (Carbamazepine), 2013	IQ <85 (DAS) (at 6 years old) (318)	during pregnancy (anytime or not specified)	exposed to other treatment, sick	3.21 [0.60;17.19]	5/61 2/74
S6188 R53300	Nadebaum (Carbamazepine), 2011	Full-scale child's IQ (Wechsler Intelligence Scale for Children (WISC)) (318)	during pregnancy (anytime or not specified)	exposed to other treatment, sick	1.82 [0.48;6.95]	-9/34 -9/9
S6106 R53305	Titze (Carbamazepine) (Controls unexposed, disease free), 2008	Learning disability (IQ<70) (German versions of the revised Wechsler Intelligence Scales for children and for adults) (318)	during pregnancy (anytime or not specified)	unexposed, disease free	13.86 [0.24;809.27]	0/4 0/49
S6112 R53306	Titze (Carbamazepine) (Controls unexposed, sick), 2008	Learning disability (IQ<70) (German versions of the revised Wechsler Intelligence Scales for children and for adults) (318)	during pregnancy (anytime or not specified)	unexposed, sick	1.10 [0.04;33.38]	0/4 1/13
S5831 R53301	Viinikainen (Carbamazepine) b, 2006	Full Scale IQ (FIQ) < 1SD Wechsler Intelligence Scale for Children (WISC III) (318)	throughout pregnancy	unexposed, sick	5.95 [0.26;138.26]	2/13 0/13
S5560 R53307	Vinten (Carbamazepine), 2005	IQ score <69 Wechsler Intelligence Scale for Children (WISC III) (Aged between 6 and 16 years) (318)	during pregnancy (anytime or not specified)	unexposed, sick	1.03 [0.28;3.83]	4/52 6/80
S5541 R53291	Adab (Carbamazepine), 2004	Mean Full Scale IQ Wechsler Intelligence Scale for Children (WISC) (Aged between 6 and 16 years) (318)	during pregnancy (anytime or not specified)	unexposed, sick	0.85 [0.45;1.60]	-9/52 -9/80
S7236 R53296	Gaily (Carbamazepine) (Controls unexposed, disease free), 2004	Full scale IQ (Wechsler Preschool and Primary Scale of Intelligence Revised (WPPSI-R) or Wechsler Intelligence Scale for Children Revised (WISC-R)) (318)	2nd and/or 3rd trimester	unexposed, disease free	0.80 [0.49;1.30]	-9/86 -9/140
S5557 R53297	Gaily (Carbamazepine) (Controls unexposed, sick), 2004	Full scale IQ (Wechsler Preschool and Primary Scale of Intelligence Revised (WPPSI-R) or Wechsler Intelligence Scale for Children Revised (WISC-R)) (318)	2nd and/or 3rd trimester	unexposed, sick	0.65 [0.34;1.26]	-9/86 -9/45