Levetiracetam (Epilepsy)

Intrauterine deaths (as a whole or unspecified)

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.
S7505
R22451		 Meador (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2020 Fetal loss (Spontaneous miscarriages and fetal death) 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No 0.76 [0.12;4.62] C
excluded (control group) 		2/99   3/113 5 99
ref
S7495
R22421		 Meador (Levetiracetam) (Controls unexposed, disease free), 2020 Fetal loss (Spontaneous miscarriages and fetal death) 1st trimester prospective cohort unexposed, disease free excluded Adjustment: No 5.47 [0.26;115.30] C
excluded (control group) 		2/99   0/106 2 99
ref
S7501
R22439		 Meador (Levetiracetam) (Controls unexposed, sick), 2020 Fetal loss (Spontaneous miscarriages and fetal death) 1st trimester prospective cohort unexposed, sick Adjustment: No 0.75 [0.03;16.45] C 2/99   0/15 2 99
ref
S8038
R24451		 Koc (Levetiracetam), 2018 Intrauterine deaths as a whole during pregnancy (anytime or not specified) retrospective cohort unexposed, sick Adjustment: No 0.55 [0.09;3.26] C 2/30   4/35 6 30
ref
S8064
R24570		 Trivedi (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2018 Spontaneous fetal loss (both spontaneous abortion before 20 weeks of gestation and stillbirths occurring after 20 weeks of gestation) 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No 0.75 [0.18;3.15] C
excluded (control group) 		4/63   4/48 8 63
ref
S8054
R24555		 Trivedi (Levetiracetam) (Controls unexposed, sick), 2018 Spontaneous fetal loss (both spontaneous abortion before 20 weeks of gestation and stillbirths occurring after 20 weeks of gestation) 1st trimester prospective cohort unexposed, sick Adjustment: Yes 1.99 [0.29;13.69] 4/63   5/178 9 63
ref
S7759
R22965		 Vajda (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2018 Intrauterine foetal death throughout pregnancy prospective cohort exposed to other treatment, sick excluded Adjustment: No 0.41 [0.09;1.85] C
excluded (control group) 		2/129   14/382 16 129
ref
S7750
R22956		 Vajda (Levetiracetam) (Controls unexposed, sick), 2018 Intrauterine foetal death throughout pregnancy prospective cohort unexposed, sick Adjustment: No 2.64 [0.24;28.75] 2/129   1/170 3 129
ref
S301
R16637		 Arkilo (Levetiracetam), 2015 Unsuccessful pregnancies (miscarriages/stillbirths) during pregnancy (anytime or not specified) retrospective cohort exposed to other treatment, sick Adjustment: No 2.44 [0.30;20.12] C 2/11   2/24 4 11
ref
S7815
R23211		 Tomson (Levetiracetam), 2015 Intrauterine death at least 1st trimester prospective cohort exposed to other treatment, sick Adjustment: No 1.11 [0.73;1.69] C 28/324   150/1,910 178 324
ref
Total 6 studies 1.15 [0.78;1.69] 202 656
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 Meador (Levetiracetam) (Controls unexposed, sick), 2020Meador, 2020 1 0.75[0.03; 16.45]2992%ROB confusion: unclearROB selection: lowROB classification: lowROB missing: lowROB mesure: moderateROB reporting: low Koc (Levetiracetam), 2018Koc, 2018 2 0.55[0.09; 3.26]6305%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Trivedi (Levetiracetam) (Controls unexposed, sick), 2018Trivedi, 2018 3 1.99[0.29; 13.69]9634%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Vajda (Levetiracetam) (Controls unexposed, sick), 2018Vajda, 2018 4 2.64[0.24; 28.75]31293%ROB confusion: criticalROB selection: moderateROB classification: lowROB missing: lowROB mesure: moderateROB reporting: moderate Arkilo (Levetiracetam), 2015Arkilo, 2015 5 2.44[0.30; 20.12]4113%ROB confusion: criticalROB selection: criticalROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Tomson (Levetiracetam), 2015Tomson, 2015 6 1.11[0.73; 1.69]17832484%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (6 studies) I2 = 0% 1.15[0.78; 1.69]2026560.210.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Levetiracetam) (Controls unexposed, sick; 2: Levetiracetam; 3: Levetiracetam) (Controls unexposed, sick; 4: Levetiracetam) (Controls unexposed, sick; 5: Levetiracetam; 6: Levetiracetam;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.15[0.78; 1.69]2026560%NAMeador (Levetiracetam) (Controls unexposed, sick), 2020 Koc (Levetiracetam), 2018 Trivedi (Levetiracetam) (Controls unexposed, sick), 2018 Vajda (Levetiracetam) (Controls unexposed, sick), 2018 Arkilo (Levetiracetam), 2015 Tomson (Levetiracetam), 2015 6 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 1.17[0.40; 3.43]203210%NAMeador (Levetiracetam) (Controls unexposed, sick), 2020 Koc (Levetiracetam), 2018 Trivedi (Levetiracetam) (Controls unexposed, sick), 2018 Vajda (Levetiracetam) (Controls unexposed, sick), 2018 4 exposed to other treatment, sickexposed to other treatment, sick 1.14[0.76; 1.73]1823350%NAArkilo (Levetiracetam), 2015 Tomson (Levetiracetam), 2015 2 Tags Adjustment   - No  - No 1.12[0.76; 1.66]1935930%NAMeador (Levetiracetam) (Controls unexposed, sick), 2020 Koc (Levetiracetam), 2018 Vajda (Levetiracetam) (Controls unexposed, sick), 2018 Arkilo (Levetiracetam), 2015 Tomson (Levetiracetam), 2015 5   - Yes  - Yes 1.99[0.29; 13.67]963 -NATrivedi (Levetiracetam) (Controls unexposed, sick), 2018 1 All studiesAll studies 1.15[0.78; 1.69]2026560%NAMeador (Levetiracetam) (Controls unexposed, sick), 2020 Koc (Levetiracetam), 2018 Trivedi (Levetiracetam) (Controls unexposed, sick), 2018 Vajda (Levetiracetam) (Controls unexposed, sick), 2018 Arkilo (Levetiracetam), 2015 Tomson (Levetiracetam), 2015 60.210.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.73.81.8900.000Meador (Levetiracetam) (Controls unexposed, sick), 2020Koc (Levetiracetam), 2018Trivedi (Levetiracetam) (Controls unexposed, sick), 2018Vajda (Levetiracetam) (Controls unexposed, sick), 2018Arkilo (Levetiracetam), 2015Tomson (Levetiracetam), 2015

Asymetry test p-value = 0.5587 (by Egger's regression)

slope=0.0453 (0.1969); intercept=0.2601 (0.4082); t=0.6371; p=0.5587

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 8064, 7759, 7505, 7495

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 5.47[0.26; 115.30]299 -NAMeador (Levetiracetam) (Controls unexposed, disease free), 2020 1 unexposed, sick controlsunexposed, sick controls 1.17[0.40; 3.43]203210%NAMeador (Levetiracetam) (Controls unexposed, sick), 2020 Koc (Levetiracetam), 2018 Trivedi (Levetiracetam) (Controls unexposed, sick), 2018 Vajda (Levetiracetam) (Controls unexposed, sick), 2018 4 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.02[0.70; 1.49]2116260%NAMeador (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2020 Trivedi (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2018 Vajda (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2018 Arkilo (Levetiracetam), 2015 Tomson (Levetiracetam), 2015 50.510.01.0