Carbamazepine (Epilepsy)

Small for gestational age (weight)

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
R63209
Bromley (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2023 Small for gestation (calculated using gender-specific scales) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No 0.28 [0.03;2.20] C
excluded (control group)
1/27   13/106 14 27
ref
S15366
R63222
Bromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Small for gestation (calculated using gender-specific scales) during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No 0.20 [0.02;1.59] C 1/27   13/80 14 27
ref
S12539
R47229
Dreier (Carbamazepine), 2021 Small for gestational age (birth weight below the 10th percentile for GA, sex and country) during pregnancy (anytime or not specified) population based cohort retrospective unexposed, sick Adjustment: Yes 1.30 [1.12;1.50] -/2,650   -/- - 2,650
ref
S8082
R24680
Aydin (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2020 Small for gestational age (birth weight) 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
R24628
Aydin (Carbamazepine) (Controls unexposed, sick), 2020 Small for gestational age (birth weight) throughout pregnancy retrospective cohort unexposed, sick Adjustment: No 8.60 [0.38;193.87] C 2/15   0/22 2 15
ref
S8145
R25041
Cohen (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2019 Small for gestational age (ICD-9 656.5, 764.0, 764.1, 764.9) early pregnancy retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: Yes 1.35 [0.51;3.61]
excluded (control group)
-/-   -/- - -
ref
S8141
R25013
Cohen (Carbamazepine) (Controls unexposed NOS), 2019 Small for gestational age (ICD-9 656.5, 764.0, 764.1, 764.9) early pregnancy retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: Yes 0.71 [0.35;1.43] -/-   41,653/1,440,631 - -
ref
S5925
R15073
Artama (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013 Small for gestational age (weight) during pregnancy (anytime or not specified) population based cohort retrospective exposed to other treatment, sick excluded Adjustment: No 1.54 [0.35;6.65] C
excluded (control group)
19/1,077   2/173 21 1,077
ref
S5909
R14888
Artama (Carbamazepine) (Controls unexposed, disease free), 2013 Small for gestational age (weight) during pregnancy (anytime or not specified) population based cohort retrospective unexposed, disease free excluded Adjustment: Yes 0.91 [0.58;1.44]
excluded (control group)
19/1,077   14,079/719,509 14,098 1,077
ref
S5917
R14984
Artama (Carbamazepine) (Controls unexposed, sick), 2013 Small for gestational age (weight) during pregnancy (anytime or not specified) population based cohort retrospective unexposed, sick Adjustment: Yes 0.74 [0.42;1.28] 19/1,077   42/1,793 61 1,077
ref
S6356
R21030
Veiby (Carbamazepine) (Controls exposed to Lamotrigine, sick) b, 2013 Small for gestational age (SGA) birth weight during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No 3.04 [0.97;9.51] C
excluded (control group)
9/67   5/103 14 67
ref
S6354
R17339
Veiby (Carbamazepine) (Controls unexposed, disease free) b, 2013 Small for gestational age (SGA) birth weight during pregnancy (anytime or not specified) prospective cohort unexposed, disease free excluded Adjustment: Yes 2.40 [1.20;4.90]
excluded (control group)
9/67   8,017/106,899 8,026 67
ref
S6355
R17335
Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013 Small for gestational age (SGA) birth weight during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No 1.78 [0.80;3.92] C 9/67   31/386 40 67
ref
S5511
R17485
Pennell (Carbamazepine), 2012 Small for gestational age (SGA) (at birth) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick Adjustment: Yes 3.14 [0.91;10.90] 12/93   4/98 16 93
ref
S6621
R18188
Burja (Carbamazepine) (Controls unexposed, disease free), 2006 Small for date (NOS) during pregnancy (anytime or not specified) retrospective cohort (registry) unexposed, disease free excluded Adjustment: No 1.53 [0.41;5.66] C
excluded (control group)
3/19   23/211 26 19
ref
S5591
R18142
Burja (Carbamazepine) (Controls unexposed, sick), 2006 Small for date (NOS) during pregnancy (anytime or not specified) retrospective cohort (registry) unexposed, sick Adjustment: No 5.81 [0.56;60.48] C 3/19   1/32 4 19
ref
S8220
R25718
Endo (Carbamazepine) (Controls unexposed, disease free), 2004 Intrauterine growth retardation (NOS) throughout pregnancy retrospective cohort unexposed, disease free excluded Adjustment: No 2.61 [0.31;21.85] C
excluded (control group)
1/8   34/656 35 8
ref
S8223
R25763
Endo (Carbamazepine) (Controls unexposed, sick), 2004 Intrauterine growth retardation (NOS) throughout pregnancy retrospective cohort unexposed, sick Adjustment: No 0.23 [0.00;17.06] C 1/8   0/1 1 8
ref
S6298
R17069
Wide (Carbamazepine), 2000 Small for gestationnal age throughout pregnancy prospective cohort unexposed (general population or NOS) Adjustment: No Matched 0.95 [0.02;49.04] C 0/39   0/37 0 39
ref
Total 10 studies 1.17 [0.79;1.73] 138 3,995
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 0.20[0.02; 1.59]14273%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: moderateROB mesure: moderateROB reporting: low Dreier (Carbamazepine), 2021Dreier, 2021 2 1.30[1.12; 1.50]-2,65032%ROB confusion: unclearROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Aydin (Carbamazepine) (Controls unexposed, sick), 2020Aydin, 2020 3 8.60[0.38; 193.87]2152%ROB confusion: criticalROB selection: criticalROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Cohen (Carbamazepine) (Controls unexposed NOS), 2019Cohen, 2019 4 0.71[0.35; 1.43]--16%ROB confusion: moderateROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Artama (Carbamazepine) (Controls unexposed, sick), 2013Artama, 2013 5 0.74[0.42; 1.28]611,07720%ROB confusion: moderateROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013Veiby, 2013 6 1.78[0.80; 3.92]406714%ROB confusion: criticalROB selection: lowROB classification: lowROB missing: moderateROB mesure: moderateROB reporting: moderate Pennell (Carbamazepine), 2012Pennell, 2012 7 3.14[0.91; 10.90]16938%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Burja (Carbamazepine) (Controls unexposed, sick), 2006Burja, 2006 8 5.81[0.56; 60.48]4193%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Endo (Carbamazepine) (Controls unexposed, sick), 2004Endo, 2004 9 0.23[0.00; 17.06]181%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Wide (Carbamazepine), 2000Wide, 2000 10 0.95[0.02; 49.04]0391%ROB confusion: criticalROB selection: lowROB classification: lowROB missing: lowROB mesure: moderateROB reporting: moderate Total (10 studies) I2 = 43% 1.17[0.79; 1.73]1383,9950.020.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

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

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.17[0.79; 1.73]1383,99543%NABromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Dreier (Carbamazepine), 2021 Aydin (Carbamazepine) (Controls unexposed, sick), 2020 Cohen (Carbamazepine) (Controls unexposed NOS), 2019 Artama (Carbamazepine) (Controls unexposed, sick), 2013 Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013 Pennell (Carbamazepine), 2012 Burja (Carbamazepine) (Controls unexposed, sick), 2006 Endo (Carbamazepine) (Controls unexposed, sick), 2004 Wide (Carbamazepine), 2000 10 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 0.72[0.36; 1.43]-390%NACohen (Carbamazepine) (Controls unexposed NOS), 2019 Wide (Carbamazepine), 2000 2 unexposed, sickunexposed, sick 1.17[0.73; 1.88]1223,86346%NABromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Dreier (Carbamazepine), 2021 Aydin (Carbamazepine) (Controls unexposed, sick), 2020 Artama (Carbamazepine) (Controls unexposed, sick), 2013 Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013 Burja (Carbamazepine) (Controls unexposed, sick), 2006 Endo (Carbamazepine) (Controls unexposed, sick), 2004 7 exposed to other treatment, sickexposed to other treatment, sick 3.14[0.91; 10.87]1693 -NAPennell (Carbamazepine), 2012 1 Tags Adjustment   - No  - No 1.43[0.49; 4.18]6117529%NABromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Aydin (Carbamazepine) (Controls unexposed, sick), 2020 Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013 Burja (Carbamazepine) (Controls unexposed, sick), 2006 Endo (Carbamazepine) (Controls unexposed, sick), 2004 Wide (Carbamazepine), 2000 6   - Yes  - Yes 1.08[0.68; 1.71]773,82064%NADreier (Carbamazepine), 2021 Cohen (Carbamazepine) (Controls unexposed NOS), 2019 Artama (Carbamazepine) (Controls unexposed, sick), 2013 Pennell (Carbamazepine), 2012 4 MatchedMatched 0.95[0.02; 49.04]-39 -NAWide (Carbamazepine), 2000 1 All studiesAll studies 1.17[0.79; 1.73]1383,99543%NABromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Dreier (Carbamazepine), 2021 Aydin (Carbamazepine) (Controls unexposed, sick), 2020 Cohen (Carbamazepine) (Controls unexposed NOS), 2019 Artama (Carbamazepine) (Controls unexposed, sick), 2013 Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013 Pennell (Carbamazepine), 2012 Burja (Carbamazepine) (Controls unexposed, sick), 2006 Endo (Carbamazepine) (Controls unexposed, sick), 2004 Wide (Carbamazepine), 2000 100.020.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-5.25.32.6350.000Bromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023Dreier (Carbamazepine), 2021Aydin (Carbamazepine) (Controls unexposed, sick), 2020Cohen (Carbamazepine) (Controls unexposed NOS), 2019Artama (Carbamazepine) (Controls unexposed, sick), 2013Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013Pennell (Carbamazepine), 2012Burja (Carbamazepine) (Controls unexposed, sick), 2006Endo (Carbamazepine) (Controls unexposed, sick), 2004Wide (Carbamazepine), 2000

Asymetry test p-value = 0.8362 (by Egger's regression)

slope=0.2402 (0.1193); intercept=-0.1172 (0.5485); t=0.2136; p=0.8362

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 8220, 6621, 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) 1.20[0.75; 1.93]63,8291,21036%NACohen (Carbamazepine) (Controls unexposed NOS), 2019 Artama (Carbamazepine) (Controls unexposed, disease free), 2013 Veiby (Carbamazepine) (Controls unexposed, disease free) b, 2013 Burja (Carbamazepine) (Controls unexposed, disease free), 2006 Endo (Carbamazepine) (Controls unexposed, disease free), 2004 Wide (Carbamazepine), 2000 6 unexposed, sick controlsunexposed, sick controls 1.17[0.73; 1.88]1223,86346%NABromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Dreier (Carbamazepine), 2021 Aydin (Carbamazepine) (Controls unexposed, sick), 2020 Artama (Carbamazepine) (Controls unexposed, sick), 2013 Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013 Burja (Carbamazepine) (Controls unexposed, sick), 2006 Endo (Carbamazepine) (Controls unexposed, sick), 2004 7 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.79[1.02; 3.16]671,2793%NABromley (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2023 Aydin (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2020 Cohen (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2019 Artama (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013 Veiby (Carbamazepine) (Controls exposed to Lamotrigine, sick) b, 2013 Pennell (Carbamazepine), 2012 60.510.01.0