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

Minor congenital malformations

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.
S16157
R67051		 Alsaadi (Valproate) (Epilepsy) (Controls exposed to LTG), 2020 Minor congenital malformations 1st trimester retrospective cohort exposed to other treatment, sick excluded Adjustment: No 0.16 [0.01;4.15] C
excluded (control group) 		0/23   1/12 1 23
ref
S16154
R67039		 Alsaadi (Valproate) (Epilepsy) (Controls unexposed sick), 2020 Minor congenital malformations 1st trimester retrospective cohort unexposed, sick Adjustment: No 1.58 [0.03;82.39] C 0/23   0/36 0 23
ref
S9299
R32356		 Dean (Valproate), 2002 Minor congenital malformations at least 1st trimester retrospective cohort unexposed, sick Adjustment: No 7.50 [2.49;22.56] C 25/47   5/38 30 47
ref
S9332
R32556		 Battino (Valproate), 1992 Minor anomalies 1st trimester prospective cohort unexposed, sick Adjustment: No 7.62 [0.38;152.84] C 6/21   0/9 6 21
ref
S9352
R32721		 Robert (Valproate), 1986 Minor malformations 1st trimester retrospective cohort unexposed, sick Adjustment: No 1.94 [0.38;9.97] C 3/15   4/35 7 15
ref
Total 4 studies 4.84 [2.06;11.36] 43 106
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 Alsaadi (Valproate) (Epilepsy) (Controls unexposed sick), 2020Alsaadi, 2020 1 1.58[0.03; 82.39]0235%ROB confusion: criticalROB selection: unclearROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Dean (Valproate), 2002Dean, 2002 2 7.50[2.49; 22.56]304760%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Battino (Valproate), 1992Battino, 1992 3 7.62[0.38; 152.84]6218%ROB confusion: criticalROB selection: moderateROB classification: lowROB missing: lowROB mesure: moderateROB reporting: moderate Robert (Valproate), 1986Robert, 1986 4 1.94[0.38; 9.97]71527%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (4 studies) I2 = 0% 4.84[2.06; 11.36]431060.520.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Valproate) (Epilepsy) (Controls unexposed sick; 2: Valproate; 3: Valproate; 4: Valproate;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 4.84[2.06; 11.36]431060%NAAlsaadi (Valproate) (Epilepsy) (Controls unexposed sick), 2020 Dean (Valproate), 2002 Battino (Valproate), 1992 Robert (Valproate), 1986 4 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 4.84[2.06; 11.36]431060%NAAlsaadi (Valproate) (Epilepsy) (Controls unexposed sick), 2020 Dean (Valproate), 2002 Battino (Valproate), 1992 Robert (Valproate), 1986 4 Tags Adjustment   - No  - No 4.84[2.06; 11.36]431060%NAAlsaadi (Valproate) (Epilepsy) (Controls unexposed sick), 2020 Dean (Valproate), 2002 Battino (Valproate), 1992 Robert (Valproate), 1986 4 All studiesAll studies 4.84[2.06; 11.36]431060%NAAlsaadi (Valproate) (Epilepsy) (Controls unexposed sick), 2020 Dean (Valproate), 2002 Battino (Valproate), 1992 Robert (Valproate), 1986 40.520.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-4.76.32.4220.000Alsaadi (Valproate) (Epilepsy) (Controls unexposed sick), 2020Dean (Valproate), 2002Battino (Valproate), 1992Robert (Valproate), 1986

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

not enought points

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 16157

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed, sick controlsunexposed, sick controls 4.84[2.06; 11.36]431060%NAAlsaadi (Valproate) (Epilepsy) (Controls unexposed sick), 2020 Dean (Valproate), 2002 Battino (Valproate), 1992 Robert (Valproate), 1986 4 exposed to other treatment, sick controlsexposed to other treatment, sick controls Out of scale0.16[0.01; 4.15]123 -NAAlsaadi (Valproate) (Epilepsy) (Controls exposed to LTG), 2020 10.510.01.0

Umbrella review (other published meta-analyses)

Published MAControlPeriodTE95% CIn exposedkI2 Veroniki a (NMA) (All indications) (Minor con ...Veroniki a (NMA) (All indications) (Minor congenital malformations) Out of scale17.76[1.60; 633.30]NA-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT-9 metaPregmetaPreg 4.84[2.06; 11.36]0%106----Alsaadi (Valproate) (Epilepsy) (Controls unexposed sick), 2020 Dean (Valproate), 2002 Battino (Valproate), 1992 Robert (Valproate), 1986 40.510.01.0