Lamotrigine (All indications) updated on 04-22-2025

Small for gestational age (weight)

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.
S16016
R66487		 Christensen (Lamotrigine) (All indications), 2024 Small for gestational age (a z-score for birth weight ≤10th percentile for gestational week, sex, and country (including newborns with congenital malformations)) during pregnancy (anytime or not specified) population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes 0.91 [0.85;0.99] 920/8,756   446,267/4,467,848 447,187 8,756
ref
S15218
R62393		 Bromley (Lamotrigine) (Epilepsy), 2023 Small for gestation (calculated using gender-specific scales) during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No 0.72 [0.31;1.65] C 13/106   13/80 26 106
ref
S12611
R47524		 Van Marter (Lamotrigine) (Controls unexposed, disease free), 2021 Small for gestational age (weight for gestational age <10th percentile) at least 1st trimester prospective cohort unexposed, disease free excluded Adjustment: No 0.10 [0.01;0.79] C
excluded (control group) 		1/106   9/102 10 106
ref
S12613
R47536		 Van Marter (Lamotrigine) (Controls unexposed, sick), 2021 Small for gestational age (weight for gestational age <10th percentile) at least 1st trimester prospective cohort unexposed, sick Adjustment: No 0.39 [0.02;10.00] C 1/106   0/14 1 106
ref
S8904
R30081		 Aydin (Lamotrigine), 2020 Small for gestational age (birth weight) throughout pregnancy retrospective cohort unexposed, sick Adjustment: No 3.31 [0.06;183.69] C 0/7   0/22 0 7
ref
S8978
R30434		 Coste (Lamotrigine) (Controls unexposed NOS) (Mixed indications), 2020 Small for gestational age (weight) during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No 1.04 [0.92;1.17] C 284/2,813   167,016/1,707,707 167,300 2,813
ref
S8963
R30354		 Cohen (Lamotrigine) (Mixed indications), 2019 Small for gestational age (ICD-9 656.5, 764.0, 764.1, 764.9) early pregnancy retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: Yes 0.86 [0.69;1.05] 106/2,682   41,653/1,440,631 41,759 2,682
ref
S8974
R30419		 Hernández-Díaz (Lamotrigine) (Mixed indications), 2014 Small for gestational age (SGA) (<10th percentile) throughout pregnancy prospective cohort unexposed, disease free Adjustment: No 1.37 [0.86;2.18] C 107/1,581   23/457 130 1,581
ref
S8953
R30313		 Veiby (Lamotrigine) (Controls unexposed, disease free) b, 2013 Small for gestational age (SGA) birth weight during pregnancy (anytime or not specified) prospective cohort unexposed, disease free excluded Adjustment: Yes 0.60 [0.20;1.40]
excluded (control group) 		5/103   8,017/106,899 8,022 103
ref
S8954
R30327		 Veiby (Lamotrigine) (Controls unexposed, sick) b, 2013 Small for gestational age (SGA) birth weight during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No 0.58 [0.22;1.54] C 5/103   31/386 36 103
ref
Total 8 studies 0.95 [0.87;1.03] 656,439 16,154
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 Christensen (Lamotrigine) (All indications), 2024Christensen, 2024 1 0.91[0.85; 0.99]447,1878,75650%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Bromley (Lamotrigine) (Epilepsy), 2023Bromley, 2023 2 0.72[0.31; 1.65]261061%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: moderateROB mesure: moderateROB reporting: low Van Marter (Lamotrigine) (Controls unexposed, sick), 2021Van Marter, 2021 3 0.39[0.02; 10.00]11060%ROB confusion: criticalROB selection: lowROB classification: lowROB missing: lowROB mesure: moderateROB reporting: low Aydin (Lamotrigine), 2020Aydin, 2020 4 3.31[0.06; 183.69]070%ROB confusion: criticalROB selection: criticalROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Coste (Lamotrigine) (Controls unexposed NOS) (Mixed indications), 2020Coste, 2020 5 1.04[0.92; 1.17]167,3002,81331%ROB confusion: criticalROB selection: moderateROB classification: criticalROB missing: moderateROB mesure: moderateROB reporting: moderate Cohen (Lamotrigine) (Mixed indications), 2019Cohen, 2019 6 0.86[0.69; 1.05]41,7592,68214%ROB confusion: moderateROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Hernández-Díaz (Lamotrigine) (Mixed indications), 2014Hernández-Díaz, 2014 7 1.37[0.86; 2.18]1301,5813%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: moderateROB mesure: moderateROB reporting: moderate Veiby (Lamotrigine) (Controls unexposed, sick) b, 2013Veiby, 2013 8 0.58[0.22; 1.54]361031%ROB confusion: seriousROB selection: lowROB classification: lowROB missing: moderateROB mesure: moderateROB reporting: moderate Total (8 studies) I2 = 16% 0.95[0.87; 1.03]656,43916,1540.210.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Lamotrigine) (All indications; 2: Lamotrigine) (Epilepsy; 3: Lamotrigine) (Controls unexposed, sick; 4: Lamotrigine; 5: Lamotrigine) (Controls unexposed NOS) (Mixed indications; 6: Lamotrigine) (Mixed indications; 7: Lamotrigine) (Mixed indications; 8: Lamotrigine) (Controls unexposed, sick) ;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 0.95[0.87; 1.03]656,43916,15416%NAChristensen (Lamotrigine) (All indications), 2024 Bromley (Lamotrigine) (Epilepsy), 2023 Van Marter (Lamotrigine) (Controls unexposed, sick), 2021 Aydin (Lamotrigine), 2020 Coste (Lamotrigine) (Controls unexposed NOS) (Mixed indications), 2020 Cohen (Lamotrigine) (Mixed indications), 2019 Hernández-Díaz (Lamotrigine) (Mixed indications), 2014 Veiby (Lamotrigine) (Controls unexposed, sick) b, 2013 8 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 0.96[0.86; 1.08]656,37615,83253%NAChristensen (Lamotrigine) (All indications), 2024 Coste (Lamotrigine) (Controls unexposed NOS) (Mixed indications), 2020 Cohen (Lamotrigine) (Mixed indications), 2019 Hernández-Díaz (Lamotrigine) (Mixed indications), 2014 4 unexposed, sickunexposed, sick 0.67[0.36; 1.24]633220%NABromley (Lamotrigine) (Epilepsy), 2023 Van Marter (Lamotrigine) (Controls unexposed, sick), 2021 Aydin (Lamotrigine), 2020 Veiby (Lamotrigine) (Controls unexposed, sick) b, 2013 4 Tags Adjustment   - No  - No 1.04[0.92; 1.17]167,4934,7160%NABromley (Lamotrigine) (Epilepsy), 2023 Van Marter (Lamotrigine) (Controls unexposed, sick), 2021 Aydin (Lamotrigine), 2020 Coste (Lamotrigine) (Controls unexposed NOS) (Mixed indications), 2020 Hernández-Díaz (Lamotrigine) (Mixed indications), 2014 Veiby (Lamotrigine) (Controls unexposed, sick) b, 2013 6   - Yes  - Yes 0.90[0.84; 0.97]488,94611,4380%NAChristensen (Lamotrigine) (All indications), 2024 Cohen (Lamotrigine) (Mixed indications), 2019 2 All studiesAll studies 0.95[0.87; 1.03]656,43916,15416%NAChristensen (Lamotrigine) (All indications), 2024 Bromley (Lamotrigine) (Epilepsy), 2023 Van Marter (Lamotrigine) (Controls unexposed, sick), 2021 Aydin (Lamotrigine), 2020 Coste (Lamotrigine) (Controls unexposed NOS) (Mixed indications), 2020 Cohen (Lamotrigine) (Mixed indications), 2019 Hernández-Díaz (Lamotrigine) (Mixed indications), 2014 Veiby (Lamotrigine) (Controls unexposed, sick) b, 2013 80.110.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-4.84.82.4590.000Christensen (Lamotrigine) (All indications), 2024Bromley (Lamotrigine) (Epilepsy), 2023Van Marter (Lamotrigine) (Controls unexposed, sick), 2021Aydin (Lamotrigine), 2020Coste (Lamotrigine) (Controls unexposed NOS) (Mixed indications), 2020Cohen (Lamotrigine) (Mixed indications), 2019Hernández-Díaz (Lamotrigine) (Mixed indications), 2014Veiby (Lamotrigine) (Controls unexposed, sick) b, 2013

Asymetry test p-value = 0.9881 (by Egger's regression)

slope=-0.0635 (0.0493); intercept=0.0087 (0.5594); t=0.0155; p=0.9881

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 8953, 12611

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 0.95[0.82; 1.09]664,40816,04157%NAChristensen (Lamotrigine) (All indications), 2024 Van Marter (Lamotrigine) (Controls unexposed, disease free), 2021 Coste (Lamotrigine) (Controls unexposed NOS) (Mixed indications), 2020 Cohen (Lamotrigine) (Mixed indications), 2019 Hernández-Díaz (Lamotrigine) (Mixed indications), 2014 Veiby (Lamotrigine) (Controls unexposed, disease free) b, 2013 6 unexposed, sick controlsunexposed, sick controls 0.67[0.36; 1.24]633220%NABromley (Lamotrigine) (Epilepsy), 2023 Van Marter (Lamotrigine) (Controls unexposed, sick), 2021 Aydin (Lamotrigine), 2020 Veiby (Lamotrigine) (Controls unexposed, sick) b, 2013 40.510.01.0

Umbrella review (other published meta-analyses)

Published MAControlPeriodTE95% CIn exposedkI2 Veroniki a (NMA) (Prenatal growth retardation)Veroniki a (NMA) (Prenatal growth retardation) 0.90[0.56; 1.42]-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT7 metaPregmetaPreg 0.95[0.87; 1.03]16%16,154----Christensen (Lamotrigine) (All indications), 2024 Bromley (Lamotrigine) (Epilepsy), 2023 Van Marter (Lamotrigine) (Controls unexposed, sick), 2021 Aydin (Lamotrigine), 2020 Coste (Lamotrigine) (Controls unexposed NOS) (Mixed indications), 2020 Cohen (Lamotrigine) (Mixed indications), 2019 Hernández-Díaz (Lamotrigine) (Mixed indications), 2014 Veiby (Lamotrigine) (Controls unexposed, sick) b, 2013 80.510.01.0