Topiramate (All indications)

ASD (Autism spectrum disorder): Diagnosis

id	Study   Auto Bjørk (Topiramate) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2022Bjørk (Topiramate) (Controls unexposed NOS) (Mixed indications), 2022Bjørk (Topiramate) (Controls unexposed, sick) (Mixed indications), 2022Coste (Topiramate) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2020Coste (Topiramate) (Controls unexposed, NOS) (Mixed indications), 2020Wood (Topiramate), 2015	Lib. in paper	Exposition period  Auto during pregnancy (anytime or not specified)1st trimester2nd trimester3rd trimester2nd and/or 3rd trimesterthroughout pregnancyearly pregnancydays before deliverylate pregnancypreconception-onlypericonceptionalpreconceptional for kinetic reasonat least 1st trimester3 months (or more) before pregnancy or during pregnancy1st and 2nd trimester3 months or more before pregnancy or1st trimester	Study type  All studies Case control excluded Only case control	Control type    Auto unexposed (general population or NOS)unexposed, sickunexposed, disease freeexposed to other treatment, sicknot specifiedwhatever (meta-analysis)	Tags	OR 95%CI	x1/n1 x0/n0	no cases	no exposed	ROB	Ref.
S12715 R47968	Bjørk (Topiramate) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2022	Diagnosis of childhood autism (F84.0), atypical autism (F84.1), and Asperger syndrome (F84.5) (between 6.1 and 7.9 years old)	during pregnancy (anytime or not specified)	population based cohort retrospective	exposed to other treatment, sick excluded	Adjustment: No	2.51 [1.36;4.63] C excluded (control group)	12/471   82/7,950	94	471		ref
S12716 R47971	Bjørk (Topiramate) (Controls unexposed NOS) (Mixed indications), 2022	Diagnosis of childhood autism (F84.0), atypical autism (F84.1), and Asperger syndrome (F84.5) (between 6.1 and 7.9 years old)	during pregnancy (anytime or not specified)	population based cohort retrospective	unexposed (general population or NOS) excluded	Adjustment: Yes	2.64 [1.50;4.65] excluded (control group)	12/471   38,437/4,463,879	38,449	471		ref
S12718 R47977	Bjørk (Topiramate) (Controls unexposed, sick) (Mixed indications), 2022	Diagnosis of childhood autism (F84.0), atypical autism (F84.1), and Asperger syndrome (F84.5) (between 6.1 and 7.9 years old)	during pregnancy (anytime or not specified)	population based cohort retrospective	unexposed, sick	Adjustment: No Controls: epilepsy indication	2.09 [1.16;3.76] C	12/471   267/21,634	279	471		ref
S10103 R36818	Coste (Topiramate) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2020	Diagnosis Pervasive developmental disorders (F84) (mean age of 3.7 years old)	during pregnancy (anytime or not specified)	retrospective cohort (claims database)	exposed to other treatment, sick excluded	Adjustment: Yes	0.55 [0.07;4.31] C excluded (control group)	1/477   11/2,916	12	477		ref
S8613 R28738	Coste (Topiramate) (Controls unexposed, NOS) (Mixed indications), 2020	Diagnosis Pervasive developmental disorders (F84) (mean age of 3.6 years old)	during pregnancy (anytime or not specified)	retrospective cohort (claims database)	unexposed (general population or NOS)	Adjustment: Yes	0.70 [0.10;4.70]	1/477   4,280/1,710,441	4,281	477		ref
S8591 R28590	Wood (Topiramate), 2015	Score >30 (CARS)	during pregnancy (anytime or not specified)	prospective cohort	exposed to other treatment, sick	Adjustment: No	17.00 [0.13;2166.90] C	0/1   0/9	0	1		ref
					Total	3 studies	1.96 [1.12;3.42]		4,560	949
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

Sensitivity analysis

Publication bias and p-hacking diagnosis

Sub-groups analysis using all included studies

excluded 10103, 12715, 12716