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

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.
S16753
R70381		 Vajda a (Levetiracetam) (Controls exposed to LTG) (Epilepsy), 2024 Intra uterine foetal death (including both spontaneous abortions and stillbirths, but not elective termination) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No 0.35 [0.08;1.61] C
excluded (control group) 		2/183   10/326 12 183
ref
S16200
R67130		 Vajda a (Levetiracetam) (Controls unexposed sick) (Epilepsy), 2024 Intra uterine foetal death (including both spontaneous abortions and stillbirths, but not elective termination) during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No 4.11 [0.20;86.35] C 2/183   0/149 2 183
ref
S8995
R30551		 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
S8996
R30555		 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
S8997
R30559		 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
S9001
R30571		 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
S9014
R30663		 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
S9015
R30664		 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
S8982
R30470		 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
S9013
R30661		 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] 201 710
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 Vajda a (Levetiracetam) (Controls unexposed sick) (Epilepsy), 2024Vajda a, 2024 1 4.11[0.20; 86.35]21832%ROB confusion: criticalROB selection: criticalROB classification: unclearROB missing: unclearROB mesure: criticalROB reporting: moderate Meador (Levetiracetam) (Controls unexposed, sick), 2020Meador, 2020 2 0.75[0.03; 16.45]2992%ROB confusion: unclearROB selection: lowROB classification: lowROB missing: lowROB mesure: moderateROB reporting: low Koc (Levetiracetam), 2018Koc, 2018 3 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 4 1.99[0.29; 13.69]9634%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA 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]17832485%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (6 studies) I2 = 0% 1.15[0.78; 1.69]2017100.210.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Levetiracetam) (Controls unexposed sick) (Epilepsy; 2: Levetiracetam) (Controls unexposed, sick; 3: Levetiracetam; 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]2017100%NAVajda a (Levetiracetam) (Controls unexposed sick) (Epilepsy), 2024 Meador (Levetiracetam) (Controls unexposed, sick), 2020 Koc (Levetiracetam), 2018 Trivedi (Levetiracetam) (Controls unexposed, sick), 2018 Arkilo (Levetiracetam), 2015 Tomson (Levetiracetam), 2015 6 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 1.16[0.38; 3.55]193750%NAVajda a (Levetiracetam) (Controls unexposed sick) (Epilepsy), 2024 Meador (Levetiracetam) (Controls unexposed, sick), 2020 Koc (Levetiracetam), 2018 Trivedi (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[0.75; 1.66]1926470%NAVajda a (Levetiracetam) (Controls unexposed sick) (Epilepsy), 2024 Meador (Levetiracetam) (Controls unexposed, sick), 2020 Koc (Levetiracetam), 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]2017100%NAVajda a (Levetiracetam) (Controls unexposed sick) (Epilepsy), 2024 Meador (Levetiracetam) (Controls unexposed, sick), 2020 Koc (Levetiracetam), 2018 Trivedi (Levetiracetam) (Controls unexposed, sick), 2018 Arkilo (Levetiracetam), 2015 Tomson (Levetiracetam), 2015 60.210.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.73.81.8900.000Vajda a (Levetiracetam) (Controls unexposed sick) (Epilepsy), 2024Meador (Levetiracetam) (Controls unexposed, sick), 2020Koc (Levetiracetam), 2018Trivedi (Levetiracetam) (Controls unexposed, sick), 2018Arkilo (Levetiracetam), 2015Tomson (Levetiracetam), 2015

Asymetry test p-value = 0.5047 (by Egger's regression)

slope=0.0294 (0.2016); intercept=0.3044 (0.4158); t=0.7321; p=0.5047

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 9014, 8995, 8996, 16753

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 1.16[0.38; 3.55]193750%NAVajda a (Levetiracetam) (Controls unexposed sick) (Epilepsy), 2024 Meador (Levetiracetam) (Controls unexposed, sick), 2020 Koc (Levetiracetam), 2018 Trivedi (Levetiracetam) (Controls unexposed, sick), 2018 4 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.02[0.70; 1.48]2076800%NAVajda a (Levetiracetam) (Controls exposed to LTG) (Epilepsy), 2024 Meador (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2020 Trivedi (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2018 Arkilo (Levetiracetam), 2015 Tomson (Levetiracetam), 2015 50.510.01.0

Umbrella review (other published meta-analyses)

Published MAControlPeriodTE95% CIn exposedkI2 Veroniki a (NMA) (All indications) (Combined ...Veroniki a (NMA) (All indications) (Combined fetal losses) 2.47[0.50; 10.15]NA-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT-9 metaPregmetaPreg 1.15[0.78; 1.69]0%710----Vajda a (Levetiracetam) (Controls unexposed sick) (Epilepsy), 2024 Meador (Levetiracetam) (Controls unexposed, sick), 2020 Koc (Levetiracetam), 2018 Trivedi (Levetiracetam) (Controls unexposed, sick), 2018 Arkilo (Levetiracetam), 2015 Tomson (Levetiracetam), 2015 60.510.01.0