Levetiracetam (Epilepsy) updated on 04-22-2025

Late intrauterine deaths (> 22 weeks) / Stillbirths

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.
S16686
R70234		 Hoeltzenbein (Levetiracetam), 2024 Stillbirth (delivery of a stillborn baby (born without any signs of life) weighing more than 500g or aged more than 24 completed gestational weeks if the weight was not known) at least 1st trimester prospective cohort exposed to other treatment, sick Adjustment: No 2.13 [0.13;34.17] C 1/221   1/469 2 221
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 6 studies 1.80 [0.52;6.28] 11 592
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 Hoeltzenbein (Levetiracetam), 2024Hoeltzenbein, 2024 1 2.13[0.13; 34.17]222120%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: moderateROB mesure: criticalROB reporting: critical Mari (Levetiracetam), 2022Mari, 2022 2 0.64[0.01; 34.59]01710%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: unclear AlSheikh (Levetiracetam) (Controls unexposed, sick), 2020AlSheikh, 2020 3 0.88[0.02; 50.20]0910%ROB confusion: criticalROB selection: moderateROB classification: unclearROB missing: unclearROB mesure: moderateROB reporting: moderate Aydin (Levetiracetam) (Controls unexposed, sick), 2020Aydin, 2020 4 2.26[0.04; 122.79]01010%ROB confusion: criticalROB selection: criticalROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Arkilo (Levetiracetam), 2015Arkilo, 2015 5 13.82[0.60; 318.14]21116%ROB confusion: criticalROB selection: criticalROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Tomson (Levetiracetam), 2015Tomson, 2015 6 0.98[0.12; 8.19]732435%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (6 studies) I2 = 0% 1.80[0.52; 6.28]115920.250.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Levetiracetam; 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 1.80[0.52; 6.28]115920%NAHoeltzenbein (Levetiracetam), 2024 Mari (Levetiracetam), 2022 AlSheikh (Levetiracetam) (Controls unexposed, sick), 2020 Aydin (Levetiracetam) (Controls unexposed, sick), 2020 Arkilo (Levetiracetam), 2015 Tomson (Levetiracetam), 2015 6 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 1.90[0.47; 7.66]115730%NAHoeltzenbein (Levetiracetam), 2024 Mari (Levetiracetam), 2022 Arkilo (Levetiracetam), 2015 Tomson (Levetiracetam), 2015 4 Tags Adjustment   - No  - No 1.80[0.52; 6.28]115920%NAHoeltzenbein (Levetiracetam), 2024 Mari (Levetiracetam), 2022 AlSheikh (Levetiracetam) (Controls unexposed, sick), 2020 Aydin (Levetiracetam) (Controls unexposed, sick), 2020 Arkilo (Levetiracetam), 2015 Tomson (Levetiracetam), 2015 6 All studiesAll studies 1.80[0.52; 6.28]115920%NAHoeltzenbein (Levetiracetam), 2024 Mari (Levetiracetam), 2022 AlSheikh (Levetiracetam) (Controls unexposed, sick), 2020 Aydin (Levetiracetam) (Controls unexposed, sick), 2020 Arkilo (Levetiracetam), 2015 Tomson (Levetiracetam), 2015 60.250.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-4.85.42.4740.000Hoeltzenbein (Levetiracetam), 2024Mari (Levetiracetam), 2022AlSheikh (Levetiracetam) (Controls unexposed, sick), 2020Aydin (Levetiracetam) (Controls unexposed, sick), 2020Arkilo (Levetiracetam), 2015Tomson (Levetiracetam), 2015

Asymetry test p-value = 0.8558 (by Egger's regression)

slope=0.2205 (1.9555); intercept=0.2426 (1.2522); t=0.1938; p=0.8558

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 1.76[0.50; 6.14]115920%NAHoeltzenbein (Levetiracetam), 2024 Mari (Levetiracetam), 2022 AlSheikh (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2020 Aydin (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2020 Arkilo (Levetiracetam), 2015 Tomson (Levetiracetam), 2015 60.510.01.0