Valproate (Epilepsy)

Caesarean

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.
S5931
R15128		 Artama (Valproate) (Controls exposed to Lamotrigine, sick), 2013 Caesarean section during pregnancy (anytime or not specified) population based cohort retrospective exposed to other treatment, sick excluded Adjustment: No 0.96 [0.62;1.47] C
excluded (control group) 		126/706   32/173 158 706
ref
S5911
R14907		 Artama (Valproate) (Controls unexposed, disease free), 2013 Caesarean section during pregnancy (anytime or not specified) population based cohort retrospective unexposed, disease free excluded Adjustment: Yes 1.16 [0.96;1.42]
excluded (control group) 		126/706   114,791/721,948 114,917 706
ref
S5919
R15003		 Artama (Valproate) (Controls unexposed, sick), 2013 Caesarean section during pregnancy (anytime or not specified) population based cohort retrospective unexposed, sick Adjustment: Yes 0.93 [0.73;1.18] 126/706   331/1,800 457 706
ref
S6261
R16728		 Borthen (Valproate) (Controls exposed to Lamotrigine, sick), 2010 Caesarean during pregnancy (anytime or not specified) population based cohort retrospective exposed to other treatment, sick excluded Adjustment: No 0.89 [0.55;1.45] C
excluded (control group) 		37/215   44/233 81 215
ref
S5684
R16672		 Borthen (Valproate) (Controls unexposed, disease free), 2010 Caesarean during pregnancy (anytime or not specified) population based cohort retrospective unexposed, disease free excluded Adjustment: Yes 1.70 [1.20;2.40]
excluded (control group) 		37/215   51,806/362,302 51,843 215
ref
S6263
R16744		 Borthen (Valproate) (Controls unexposed, sick), 2010 Caesarean during pregnancy (anytime or not specified) population based cohort retrospective unexposed, sick Adjustment: No 0.94 [0.65;1.37] C 37/215   337/1,863 374 215
ref
S8221
R25736		 Endo (Valproate) (Controls unexposed, disease free), 2004 Cesarean section at least 1st trimester retrospective cohort unexposed, disease free excluded Adjustment: No 0.87 [0.05;16.27] C
excluded (control group) 		0/5   74/656 74 5
ref
S8311
R26293		 Endo (Valproate) (Controls unexposed, sick), 2004 Cesarean section throughout pregnancy retrospective cohort unexposed, sick Adjustment: No 0.11 [0.00;14.76] C 0/5   0/1 0 5
ref
S5495
R16631		 Jäger-Roman (Valproate), 1986 Caesarean section at least 1st trimester excluded prospective cohort unexposed (general population or NOS) Adjustment: No 5.40 [1.38;21.12] C
excluded (exposition period) 		4/14   8/116 12 14
ref
Total 3 studies 0.93 [0.76;1.14] 831 926
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 Artama (Valproate) (Controls unexposed, sick), 2013Artama, 2013 1 0.93[0.73; 1.18]45770671%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Borthen (Valproate) (Controls unexposed, sick), 2010Borthen, 2010 2 0.94[0.65; 1.37]37421529%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Endo (Valproate) (Controls unexposed, sick), 2004Endo, 2004 3 0.11[0.00; 14.76]050%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (3 studies) I2 = 0% 0.93[0.76; 1.14]8319260.02.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Valproate) (Controls unexposed, sick; 2: Valproate) (Controls unexposed, sick; 3: Valproate) (Controls unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 0.93[0.76; 1.14]8319260%NAArtama (Valproate) (Controls unexposed, sick), 2013 Borthen (Valproate) (Controls unexposed, sick), 2010 Endo (Valproate) (Controls unexposed, sick), 2004 3 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 0.93[0.76; 1.14]8319260%NAArtama (Valproate) (Controls unexposed, sick), 2013 Borthen (Valproate) (Controls unexposed, sick), 2010 Endo (Valproate) (Controls unexposed, sick), 2004 3 Tags Adjustment   - No  - No 0.93[0.64; 1.35]3742200%NABorthen (Valproate) (Controls unexposed, sick), 2010 Endo (Valproate) (Controls unexposed, sick), 2004 2   - Yes  - Yes 0.93[0.73; 1.18]457706 -NAArtama (Valproate) (Controls unexposed, sick), 2013 1 All studiesAll studies 0.93[0.76; 1.14]8319260%NAArtama (Valproate) (Controls unexposed, sick), 2013 Borthen (Valproate) (Controls unexposed, sick), 2010 Endo (Valproate) (Controls unexposed, sick), 2004 30.010.01.0

Publication bias and p-hacking diagnosis

funnel plot

Funnel plot not drawn. Less than 3 points.

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

not enought points

p values plot

Funnel plot not drawn. Less than 3 points.

Sub-groups analysis using all included studies

excluded 8221, 6261, 5684, 5931, 5911

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.37[0.94; 1.98]166,76092172%NAArtama (Valproate) (Controls unexposed, disease free), 2013 Borthen (Valproate) (Controls unexposed, disease free), 2010 2 unexposed, sick controlsunexposed, sick controls 0.93[0.76; 1.14]8319260%NAArtama (Valproate) (Controls unexposed, sick), 2013 Borthen (Valproate) (Controls unexposed, sick), 2010 Endo (Valproate) (Controls unexposed, sick), 2004 3 exposed to other treatment, sick controlsexposed to other treatment, sick controls 0.93[0.67; 1.28]2399210%NAArtama (Valproate) (Controls exposed to Lamotrigine, sick), 2013 Borthen (Valproate) (Controls exposed to Lamotrigine, sick), 2010 20.510.01.0