Levetiracetam (Epilepsy)

Late intrauterine deaths (> 22 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.
S12502
R47877		 Mari (Levetiracetam), 2022 Stillborn throughout pregnancy retrospective cohort exposed to other treatment, sick Adjustment: No 0.64 [0.01;34.59] C 0/17   0/11 0 17
ref
S7999
R24367		 AlSheikh (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2020 Stillbirth during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No 2.29 [0.04;125.50] C
excluded (control group) 		0/9   0/20 0 9
ref
S8000
R24369		 AlSheikh (Levetiracetam) (Controls unexposed, sick), 2020 Stillbirth during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No 0.88 [0.02;50.20] C 0/9   0/8 0 9
ref
S8083
R24693		 Aydin (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2020 Intrauterine fetal demise throughout pregnancy retrospective cohort exposed to other treatment, sick excluded Adjustment: No 0.68 [0.01;39.07] C
excluded (control group) 		0/10   0/7 0 10
ref
S8081
R24673		 Aydin (Levetiracetam) (Controls unexposed, sick), 2020 Intrauterine fetal demise throughout pregnancy retrospective cohort unexposed, sick Adjustment: No 2.26 [0.04;122.79] C 0/10   0/22 0 10
ref
S301
R16639		 Arkilo (Levetiracetam), 2015 Stillbirth during pregnancy (anytime or not specified) retrospective cohort exposed to other treatment, sick Adjustment: No 13.82 [0.60;318.14] C 2/11   0/24 2 11
ref
S7815
R23210		 Tomson (Levetiracetam), 2015 Stillbirths at least 1st trimester prospective cohort exposed to other treatment, sick Adjustment: No 0.98 [0.12;8.19] C 1/324   6/1,910 7 324
ref
Total 5 studies 1.72 [0.43;6.99] 9 371
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 Mari (Levetiracetam), 2022Mari, 2022 1 0.64[0.01; 34.59]01712%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: unclear AlSheikh (Levetiracetam) (Controls unexposed, sick), 2020AlSheikh, 2020 2 0.88[0.02; 50.20]0912%ROB confusion: criticalROB selection: moderateROB classification: unclearROB missing: unclearROB mesure: moderateROB reporting: moderate Aydin (Levetiracetam) (Controls unexposed, sick), 2020Aydin, 2020 3 2.26[0.04; 122.79]01012%ROB confusion: criticalROB selection: criticalROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Arkilo (Levetiracetam), 2015Arkilo, 2015 4 13.82[0.60; 318.14]21120%ROB confusion: criticalROB selection: criticalROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Tomson (Levetiracetam), 2015Tomson, 2015 5 0.98[0.12; 8.19]732444%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (5 studies) I2 = 0% 1.72[0.43; 6.99]93710.250.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

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

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.72[0.43; 6.99]93710%NAMari (Levetiracetam), 2022 AlSheikh (Levetiracetam) (Controls unexposed, sick), 2020 Aydin (Levetiracetam) (Controls unexposed, sick), 2020 Arkilo (Levetiracetam), 2015 Tomson (Levetiracetam), 2015 5 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 1.42[0.08; 24.34]-190%NAAlSheikh (Levetiracetam) (Controls unexposed, sick), 2020 Aydin (Levetiracetam) (Controls unexposed, sick), 2020 2 exposed to other treatment, sickexposed to other treatment, sick 1.89[0.34; 10.52]93529%NAMari (Levetiracetam), 2022 Arkilo (Levetiracetam), 2015 Tomson (Levetiracetam), 2015 3 Tags Adjustment   - No  - No 1.72[0.43; 6.99]93710%NAMari (Levetiracetam), 2022 AlSheikh (Levetiracetam) (Controls unexposed, sick), 2020 Aydin (Levetiracetam) (Controls unexposed, sick), 2020 Arkilo (Levetiracetam), 2015 Tomson (Levetiracetam), 2015 5 All studiesAll studies 1.72[0.43; 6.99]93710%NAMari (Levetiracetam), 2022 AlSheikh (Levetiracetam) (Controls unexposed, sick), 2020 Aydin (Levetiracetam) (Controls unexposed, sick), 2020 Arkilo (Levetiracetam), 2015 Tomson (Levetiracetam), 2015 50.250.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-4.85.42.4740.000Mari (Levetiracetam), 2022AlSheikh (Levetiracetam) (Controls unexposed, sick), 2020Aydin (Levetiracetam) (Controls unexposed, sick), 2020Arkilo (Levetiracetam), 2015Tomson (Levetiracetam), 2015

Asymetry test p-value = 0.8621 (by Egger's regression)

slope=0.1237 (2.3149); intercept=0.2741 (1.4500); t=0.1890; p=0.8621

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 7999, 8083

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed, sick controlsunexposed, sick controls 1.42[0.08; 24.34]-190%NAAlSheikh (Levetiracetam) (Controls unexposed, sick), 2020 Aydin (Levetiracetam) (Controls unexposed, sick), 2020 2 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.68[0.41; 6.79]93710%NAMari (Levetiracetam), 2022 AlSheikh (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2020 Aydin (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2020 Arkilo (Levetiracetam), 2015 Tomson (Levetiracetam), 2015 50.510.01.0