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

Maternal consequences (as a whole)

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.
S16565
R69615
Razaz (Valproate) (Epilepsy), 2024 Severe maternal morbidity (severe preeclampsia, severe hemorrhage, surgical complications, sepsis, obstetric shock, cardiac complications, kidney failure, cerebrovascular morbidity, complications of anesthesia and obstetric interventions and/or severe mental health conditions) during pregnancy (anytime or not specified) population based cohort retrospective unexposed, sick Adjustment: Yes 1.67 [1.26;2.23] 78/1,895   656/19,043 734 1,895
ref
S12706
R47942
Alsfouk (Valproate), 2022 Maternal complication (bleeding during pregnancy, gestational hypertension, eclampsia, preeclampsia, gestational diabetes, cervical cerclage, placenta abruption, prolonged labor, pre-mature rupture of membranes, seizure on day of delivery or during delivery, and post-partum hemorrhage) during pregnancy (anytime or not specified) retrospective cohort exposed to other treatment, sick Adjustment: No 2.86 [0.52;15.77] C 5/12   3/15 8 12
ref
S9441
R33150
Wen (Valproate) (Mixed indications), 2017 Pregnancy and obstetrical complications during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No 1.32 [1.00;1.74] C 76/226   12,176/43,956 12,252 226
ref
Total 3 studies 1.49 [1.23;1.82] 12,994 2,133
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 Razaz (Valproate) (Epilepsy), 2024Razaz, 2024 1 1.67[1.26; 2.23]7341,89548%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Alsfouk (Valproate), 2022Alsfouk, 2022 2 2.86[0.52; 15.77]8121%ROB confusion: criticalROB selection: criticalROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Wen (Valproate) (Mixed indications), 2017Wen, 2017 3 1.32[1.00; 1.74]12,25222651%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (3 studies) I2 = 0% 1.49[1.23; 1.82]12,9942,1330.510.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Valproate) (Epilepsy; 2: Valproate; 3: Valproate) (Mixed indications;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.49[1.23; 1.82]12,9942,1330%NARazaz (Valproate) (Epilepsy), 2024 Alsfouk (Valproate), 2022 Wen (Valproate) (Mixed indications), 2017 3 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.32[1.00; 1.74]12,252226 -NAWen (Valproate) (Mixed indications), 2017 1 unexposed, sickunexposed, sick 1.67[1.26; 2.22]7341,895 -NARazaz (Valproate) (Epilepsy), 2024 1 exposed to other treatment, sickexposed to other treatment, sick 2.86[0.52; 15.77]812 -NAAlsfouk (Valproate), 2022 1 Tags Adjustment   - No  - No 1.35[1.03; 1.77]12,2602380%NAAlsfouk (Valproate), 2022 Wen (Valproate) (Mixed indications), 2017 2   - Yes  - Yes 1.67[1.26; 2.22]7341,895 -NARazaz (Valproate) (Epilepsy), 2024 1 All studiesAll studies 1.49[1.23; 1.82]12,9942,1330%NARazaz (Valproate) (Epilepsy), 2024 Alsfouk (Valproate), 2022 Wen (Valproate) (Mixed indications), 2017 30.510.01.0

Publication bias and p-hacking diagnosis

funnel plot

Funnel plot not drawn. Less than 3 points.

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

not enought points

p values plot

Funnel plot not drawn. Less than 3 points.

Sub-groups analysis using all included studies

excluded

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.32[1.00; 1.74]12,252226 -NAWen (Valproate) (Mixed indications), 2017 1 unexposed, sick controlsunexposed, sick controls 1.67[1.26; 2.22]7341,895 -NARazaz (Valproate) (Epilepsy), 2024 1 exposed to other treatment, sick controlsexposed to other treatment, sick controls 2.86[0.52; 15.77]812 -NAAlsfouk (Valproate), 2022 10.510.01.0