Carbamazepine (Epilepsy)

Preterm (< 37 weeks)

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.
S15365
R63208
Bromley (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2023 Preterm birth (gestational age < 37 weeks) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No 0.76 [0.20;2.84] C
excluded (control group)
3/27   15/106 18 27
ref
S15366
R63221
Bromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Preterm birth (gestational age < 37 weeks) during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No 0.78 [0.20;3.05] C 3/27   11/80 14 27
ref
S8082
R24678
Aydin (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2020 Preterm delivery (before 37 weeks of gestation) throughout pregnancy retrospective cohort exposed to other treatment, sick excluded Adjustment: No 2.60 [0.11;62.58] C
excluded (control group)
2/15   0/7 2 15
ref
S8074
R24626
Aydin (Carbamazepine) (Controls unexposed, sick), 2020 Preterm delivery (before 37 weeks of gestation) throughout pregnancy retrospective cohort unexposed, sick Adjustment: No 1.54 [0.19;12.32] C 2/15   2/22 4 15
ref
S10075
R36692
Coste (Carbamazepine), 2020 Gestational age at birth (< 37 WA) during pregnancy (anytime or not specified) retrospective cohort (claims database) exposed to other treatment, sick Adjustment: No 0.81 [0.41;1.63] C 9/176   131/2,108 140 176
ref
S8145
R25042
Cohen (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2019 Preterm birth (ICD-9 644.2, 774.2, 776.6, 362.20, 362.22, 362.27, 765 excluding 765.20, 765.29) early pregnancy retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: Yes 1.24 [0.78;1.96]
excluded (control group)
-/-   -/- - -
ref
S8141
R25014
Cohen (Carbamazepine) (Controls unexposed NOS), 2019 Preterm birth (ICD-9 644.2, 774.2, 776.6, 362.20, 362.22, 362.27, 765 excluding 765.20, 765.29) early pregnancy retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: Yes 0.84 [0.59;1.18] -/-   160,604/1,440,631 - -
ref
S6253
R16654
Arkilo (Carbamazepine), 2015 Premature delivery during pregnancy (anytime or not specified) retrospective cohort exposed to other treatment, sick Adjustment: No 3.52 [0.68;18.07] C 5/14   3/22 8 14
ref
S5925
R15071
Artama (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013 Preterm birth (<37 gestational weeks) during pregnancy (anytime or not specified) population based cohort retrospective exposed to other treatment, sick excluded Adjustment: No 1.17 [0.55;2.50] C
excluded (control group)
58/1,077   8/173 66 1,077
ref
S5909
R14886
Artama (Carbamazepine) (Controls unexposed, disease free), 2013 Preterm birth (<37 gestational weeks) during pregnancy (anytime or not specified) population based cohort retrospective unexposed, disease free excluded Adjustment: Yes 1.32 [1.01;1.72]
excluded (control group)
58/1,077   30,027/719,509 30,085 1,077
ref
S5917
R14982
Artama (Carbamazepine) (Controls unexposed, sick), 2013 Preterm birth (<37 gestational weeks) during pregnancy (anytime or not specified) population based cohort retrospective unexposed, sick Adjustment: Yes 1.13 [0.80;1.60] 58/1,077   85/1,793 143 1,077
ref
S6356
R21027
Veiby (Carbamazepine) (Controls exposed to Lamotrigine, sick) b, 2013 Preterm delivery (< 37 weeks) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No 0.87 [0.24;3.10] C
excluded (control group)
4/67   7/103 11 67
ref
S6354
R17337
Veiby (Carbamazepine) (Controls unexposed, disease free) b, 2013 Preterm delivery (< 37 weeks) during pregnancy (anytime or not specified) prospective cohort unexposed, disease free excluded Adjustment: No 0.80 [0.30;2.30]
excluded (control group)
4/67   7,269/106,899 7,273 67
ref
S6355
R17333
Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013 Preterm delivery (< 37 weeks) during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No 0.75 [0.26;2.21] C 4/67   30/386 34 67
ref
S5511
R17486
Pennell (Carbamazepine), 2012 Preterm Birth (< 37 weeks GA) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick Adjustment: No 1.85 [0.64;5.30] C 10/93   6/98 16 93
ref
S6941
R19600
Cummings (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2011 Preterm (35-37 weeks) throughout pregnancy retrospective cohort (registry) exposed to other treatment, sick excluded Adjustment: No 0.53 [0.13;2.15] C
excluded (control group)
4/49   5/35 9 49
ref
S6939
R19596
Cummings (Carbamazepine) (Controls unexposed, disease free), 2011 Preterm (35-37 weeks) throughout pregnancy retrospective cohort (registry) unexposed, disease free Adjustment: No 8.80 [0.46;168.35] C 4/49   0/44 4 49
ref
S6188
R16299
Nadebaum (Carbamazepine), 2011 Born premature (<37 wk) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick Adjustment: No 0.78 [0.03;21.03] C 1/34   0/9 1 34
ref
S6424
R17672
McVearry (Carbamazepine), 2009 Premature birth during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick Adjustment: No 6.11 [0.27;138.46] C 2/16   0/17 2 16
ref
S8220
R25726
Endo (Carbamazepine) (Controls unexposed, disease free), 2004 Preterm delivery (< week 37) throughout pregnancy retrospective cohort unexposed, disease free excluded Adjustment: No 2.12 [0.41;11.09] C
excluded (control group)
2/7   104/656 106 7
ref
S8223
R25771
Endo (Carbamazepine) (Controls unexposed, sick), 2004 Preterm delivery (< week 37) throughout pregnancy retrospective cohort unexposed, sick Adjustment: No 0.56 [0.01;37.57] C 2/7   0/1 2 7
ref
S5578
R14510
Diav-Citrin (Carbamazepine), 2001 Premature infants (week < 37) at least 1st trimester prospective cohort unexposed (general population or NOS) Adjustment: No Matched 2.41 [0.90;6.48] C 9/91   8/184 17 91
ref
S6823
R19287
Van der Pol (Carbamazepine) (Controls unexposed, disease free), 1991 Gestational age (≤ 37 wk) throughout pregnancy prospective cohort unexposed, disease free excluded Adjustment: No Matched 0.53 [0.03;10.70] C
excluded (control group)
0/11   4/55 4 11
ref
S6825
R19337
Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 Gestational age (≤ 37 wk) throughout pregnancy prospective cohort unexposed, sick Adjustment: No 0.37 [0.02;8.48] C 0/11   2/22 2 11
ref
Total 14 studies 1.05 [0.85;1.29] 387 1,677
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 Bromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023Bromley, 2023 1 0.78[0.20; 3.05]14272%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: moderateROB mesure: moderateROB reporting: low Aydin (Carbamazepine) (Controls unexposed, sick), 2020Aydin, 2020 2 1.54[0.19; 12.32]4151%ROB confusion: criticalROB selection: criticalROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Coste (Carbamazepine), 2020Coste, 2020 3 0.81[0.41; 1.63]1401769%ROB confusion: criticalROB selection: moderateROB classification: criticalROB missing: moderateROB mesure: moderateROB reporting: moderate Cohen (Carbamazepine) (Controls unexposed NOS), 2019Cohen, 2019 4 0.84[0.59; 1.18]--36%ROB confusion: moderateROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Arkilo (Carbamazepine), 2015Arkilo, 2015 5 3.52[0.68; 18.07]8142%ROB confusion: criticalROB selection: criticalROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Artama (Carbamazepine) (Controls unexposed, sick), 2013Artama, 2013 6 1.13[0.80; 1.60]1431,07736%ROB confusion: moderateROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013Veiby, 2013 7 0.75[0.26; 2.21]34674%ROB confusion: criticalROB selection: lowROB classification: lowROB missing: moderateROB mesure: moderateROB reporting: moderate Pennell (Carbamazepine), 2012Pennell, 2012 8 1.85[0.64; 5.30]16934%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Cummings (Carbamazepine) (Controls unexposed, disease free), 2011Cummings, 2011 9 8.80[0.46; 168.35]4490%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: unclearROB mesure: lowROB reporting: moderate Nadebaum (Carbamazepine), 2011Nadebaum, 2011 10 0.78[0.03; 21.03]1340%ROB confusion: criticalROB selection: lowROB classification: lowROB missing: criticalROB mesure: lowROB reporting: moderate McVearry (Carbamazepine), 2009McVearry, 2009 11 6.11[0.27; 138.46]2160%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Endo (Carbamazepine) (Controls unexposed, sick), 2004Endo, 2004 12 0.56[0.01; 37.57]270%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Diav-Citrin (Carbamazepine), 2001Diav-Citrin, 2001 13 2.41[0.90; 6.48]17914%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991Van der Pol, 1991 14 0.37[0.02; 8.48]2110%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Total (14 studies) I2 = 0% 1.05[0.85; 1.29]3871,6770.220.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

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

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.05[0.85; 1.29]3871,6770%NABromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Aydin (Carbamazepine) (Controls unexposed, sick), 2020 Coste (Carbamazepine), 2020 Cohen (Carbamazepine) (Controls unexposed NOS), 2019 Arkilo (Carbamazepine), 2015 Artama (Carbamazepine) (Controls unexposed, sick), 2013 Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013 Pennell (Carbamazepine), 2012 Cummings (Carbamazepine) (Controls unexposed, disease free), 2011 Nadebaum (Carbamazepine), 2011 McVearry (Carbamazepine), 2009 Endo (Carbamazepine) (Controls unexposed, sick), 2004 Diav-Citrin (Carbamazepine), 2001 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 14 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.59[0.55; 4.57]2114067%NACohen (Carbamazepine) (Controls unexposed NOS), 2019 Cummings (Carbamazepine) (Controls unexposed, disease free), 2011 Diav-Citrin (Carbamazepine), 2001 3 unexposed, sickunexposed, sick 1.06[0.78; 1.45]1991,2040%NABromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Aydin (Carbamazepine) (Controls unexposed, sick), 2020 Artama (Carbamazepine) (Controls unexposed, sick), 2013 Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013 Endo (Carbamazepine) (Controls unexposed, sick), 2004 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 6 exposed to other treatment, sickexposed to other treatment, sick 1.35[0.72; 2.53]16733313%NACoste (Carbamazepine), 2020 Arkilo (Carbamazepine), 2015 Pennell (Carbamazepine), 2012 Nadebaum (Carbamazepine), 2011 McVearry (Carbamazepine), 2009 5 Tags Adjustment   - No  - No 1.26[0.85; 1.87]2446000%NABromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Aydin (Carbamazepine) (Controls unexposed, sick), 2020 Coste (Carbamazepine), 2020 Arkilo (Carbamazepine), 2015 Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013 Pennell (Carbamazepine), 2012 Cummings (Carbamazepine) (Controls unexposed, disease free), 2011 Nadebaum (Carbamazepine), 2011 McVearry (Carbamazepine), 2009 Endo (Carbamazepine) (Controls unexposed, sick), 2004 Diav-Citrin (Carbamazepine), 2001 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 12   - Yes  - Yes 0.97[0.73; 1.30]1431,07729%NACohen (Carbamazepine) (Controls unexposed NOS), 2019 Artama (Carbamazepine) (Controls unexposed, sick), 2013 2 MatchedMatched 2.41[0.90; 6.48]1791 -NADiav-Citrin (Carbamazepine), 2001 1 All studiesAll studies 1.05[0.85; 1.29]3871,6770%NABromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Aydin (Carbamazepine) (Controls unexposed, sick), 2020 Coste (Carbamazepine), 2020 Cohen (Carbamazepine) (Controls unexposed NOS), 2019 Arkilo (Carbamazepine), 2015 Artama (Carbamazepine) (Controls unexposed, sick), 2013 Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013 Pennell (Carbamazepine), 2012 Cummings (Carbamazepine) (Controls unexposed, disease free), 2011 Nadebaum (Carbamazepine), 2011 McVearry (Carbamazepine), 2009 Endo (Carbamazepine) (Controls unexposed, sick), 2004 Diav-Citrin (Carbamazepine), 2001 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 140.120.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-5.15.12.5800.000Bromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023Aydin (Carbamazepine) (Controls unexposed, sick), 2020Coste (Carbamazepine), 2020Cohen (Carbamazepine) (Controls unexposed NOS), 2019Arkilo (Carbamazepine), 2015Artama (Carbamazepine) (Controls unexposed, sick), 2013Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013Pennell (Carbamazepine), 2012Cummings (Carbamazepine) (Controls unexposed, disease free), 2011Nadebaum (Carbamazepine), 2011McVearry (Carbamazepine), 2009Endo (Carbamazepine) (Controls unexposed, sick), 2004Diav-Citrin (Carbamazepine), 2001Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991

Asymetry test p-value = 0.1762 (by Egger's regression)

slope=-0.1166 (0.1514); intercept=0.5482 (0.3814); t=1.4371; p=0.1762

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 6823, 8220, 6941, 5925, 5909, 6356, 6354, 8145, 8082, 15365

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.19[0.83; 1.68]198,0841,30236%NACohen (Carbamazepine) (Controls unexposed NOS), 2019 Artama (Carbamazepine) (Controls unexposed, disease free), 2013 Veiby (Carbamazepine) (Controls unexposed, disease free) b, 2013 Cummings (Carbamazepine) (Controls unexposed, disease free), 2011 Endo (Carbamazepine) (Controls unexposed, disease free), 2004 Diav-Citrin (Carbamazepine), 2001 Van der Pol (Carbamazepine) (Controls unexposed, disease free), 1991 7 unexposed, sick controlsunexposed, sick controls 1.06[0.78; 1.45]1991,2040%NABromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Aydin (Carbamazepine) (Controls unexposed, sick), 2020 Artama (Carbamazepine) (Controls unexposed, sick), 2013 Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013 Endo (Carbamazepine) (Controls unexposed, sick), 2004 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 6 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.14[0.85; 1.53]2731,5680%NABromley (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2023 Aydin (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2020 Coste (Carbamazepine), 2020 Cohen (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2019 Arkilo (Carbamazepine), 2015 Artama (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013 Veiby (Carbamazepine) (Controls exposed to Lamotrigine, sick) b, 2013 Pennell (Carbamazepine), 2012 Cummings (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2011 Nadebaum (Carbamazepine), 2011 McVearry (Carbamazepine), 2009 110.510.01.0