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

Small for gestational age (weight)

id	Study   Auto The NAAED (Phenytoin) (Controls exposed to LTG) (Indications NOS), 2025The NAAED (Phenytoin) (Controls unexposed, disease free) (Indications NOS), 2025Christensen (Phenytoin) (All indications) (Controls exposed to LTG), 2024Christensen (Phenytoin) (All indications) (Controls unexposed, general population), 2024Aydin (Phenytoin) (Controls exposed to Lamotrigine, sick), 2020Aydin (Phenytoin) (Controls unexposed, sick), 2020Bank (Phenytoin) (Mixed indications), 2017Pennell (Phenytoin), 2012Wide (Phenytoin), 2000	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 trimesterPaternal exp. genotoxic window only (0–3 months preconception)Paternal exposure: epigenetic window only (3–xxx months preconception)Paternal exposure: genotoxic/epigenetic window (0–xxx months preconception)Paternal exposure: other window	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 specifiedsiblingwhatever (meta-analysis)	Tags	OR 95%CI	x1/n1 x0/n0	no cases	no exposed	ROB	Ref.
S16188 R79434	The NAAED (Phenytoin) (Controls exposed to LTG) (Indications NOS), 2025	Small for gestational age	at least 1st trimester	prospective cohort	exposed to other treatment, sick excluded	Adjustment: No	0.70 [0.45;1.11] C excluded (control group)	22/423   178/2,461	200	423		ref
S16178 R79432	The NAAED (Phenytoin) (Controls unexposed, disease free) (Indications NOS), 2025	Small for gestational age	at least 1st trimester	prospective cohort	unexposed, disease free	Adjustment: No	0.53 [0.33;0.84] C	22/423   124/1,311	146	423		ref
S16075 R66710	Christensen (Phenytoin) (All indications) (Controls exposed to LTG), 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	exposed to other treatment, sick excluded	Adjustment: No	0.81 [0.37;1.75] C excluded (control group)	7/81   920/8,756	927	81		ref
S16049 R66611	Christensen (Phenytoin) (All indications) (Controls unexposed, general population), 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	0.79 [0.36;1.73]	7/81   446,267/4,467,848	446,274	81		ref
S9192 R31821	Aydin (Phenytoin) (Controls exposed to Lamotrigine, sick), 2020	Small for gestational age (birth weight)	throughout pregnancy	retrospective cohort	exposed to other treatment, sick excluded	Adjustment: No	13.00 [0.10;1680.94] C excluded (control group)	0/1   0/7	0	1		ref
S9193 R31831	Aydin (Phenytoin) (Controls unexposed, sick), 2020	Small for gestational age (birth weight)	throughout pregnancy	retrospective cohort	unexposed, sick	Adjustment: No	43.00 [0.35;5328.22] C	0/1   0/22	0	1		ref
S9272 R32151	Bank (Phenytoin) (Mixed indications), 2017	Small for Gestational Age birthweight (<10th percentile)	during pregnancy (anytime or not specified)	prospective cohort	exposed to other treatment, sick	Adjustment: No	1.86 [0.07;46.97] C	0/3   3/36	3	3		ref
S9216 R31975	Pennell (Phenytoin), 2012	Small for gestational age (SGA) (at birth)	during pregnancy (anytime or not specified)	prospective cohort	exposed to other treatment, sick	Adjustment: Yes	0.56 [0.09;3.46]	2/55   4/98	6	55		ref
S9223 R31998	Wide (Phenytoin), 2000	Small for gestationnal age	throughout pregnancy	prospective cohort	unexposed (general population or NOS)	Adjustment: No Matched	0.86 [0.02;45.54] C	0/22   0/19	0	22		ref
					Total	6 studies	0.61 [0.42;0.90]		446,429	585
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 9192, 16075, 16188

Umbrella review (other published meta-analyses)