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

Digestive system anomalies

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.
S17499
R73523		 Wiggs (Epilepsy) (Valproate), 2024 Digestive system malformations early pregnancy population based cohort retrospective unexposed, sick Adjustment: Yes 1.52 [0.71;3.27] -/624   -/12,666 - 624
ref
S12862
R48540		 Thomas (Valproate) (Controls exposed to Lamotrigine, sick), 2021 Gastro-intestinal malformations 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No 0.15 [0.00;7.41] C
excluded (control group) 		0/341   0/50 0 341
ref
S12864
R48552		 Thomas (Valproate) (Controls unexposed, sick), 2021 Gastro-intestinal malformations 1st trimester prospective cohort unexposed, sick Adjustment: No 0.33 [0.01;8.16] C 0/341   1/340 1 341
ref
S9333
R32561		 Campbell (Valproate) (Controls exposed to Lamotrigine, sick), 2014 Gastrointestinal tract defect 1st trimester prospective cohort exposed to other treatment, sick Adjustment: No 1.51 [0.55;4.17] C 7/1,220   8/2,098 15 1,220
ref
S9325
R32509		 Veiby (Valproate) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2014 Digestive throughout pregnancy population based cohort retrospective exposed to other treatment, sick Adjustment: No 1.88 [0.42;8.46] C 3/333   4/833 7 333
ref
Total 4 studies 1.49 [0.85;2.60] 23 2,518
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 Wiggs (Epilepsy) (Valproate), 2024Wiggs, 2024 1 1.52[0.71; 3.27]-62453%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Thomas (Valproate) (Controls unexposed, sick), 2021Thomas, 2021 2 0.33[0.01; 8.16]13413%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Campbell (Valproate) (Controls exposed to Lamotrigine, sick), 2014Campbell, 2014 3 1.51[0.55; 4.17]151,22030%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Veiby (Valproate) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2014Veiby, 2014 4 1.88[0.42; 8.46]733314%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: moderateROB mesure: moderateROB reporting: moderate Total (4 studies) I2 = 0% 1.49[0.85; 2.60]232,5180.25.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Epilepsy) (Valproate; 2: Valproate) (Controls unexposed, sick; 3: Valproate) (Controls exposed to Lamotrigine, sick; 4: Valproate) (Controls exposed to Lamotrigine, sick) (Mixed indications;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.49[0.85; 2.60]232,5180%NAWiggs (Epilepsy) (Valproate), 2024 Thomas (Valproate) (Controls unexposed, sick), 2021 Campbell (Valproate) (Controls exposed to Lamotrigine, sick), 2014 Veiby (Valproate) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2014 4 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 1.40[0.67; 2.94]19650%NAWiggs (Epilepsy) (Valproate), 2024 Thomas (Valproate) (Controls unexposed, sick), 2021 2 exposed to other treatment, sickexposed to other treatment, sick 1.62[0.70; 3.75]221,5530%NACampbell (Valproate) (Controls exposed to Lamotrigine, sick), 2014 Veiby (Valproate) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2014 2 Tags Adjustment   - No  - No 1.46[0.65; 3.30]231,8940%NAThomas (Valproate) (Controls unexposed, sick), 2021 Campbell (Valproate) (Controls exposed to Lamotrigine, sick), 2014 Veiby (Valproate) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2014 3   - Yes  - Yes 1.52[0.71; 3.26]-624 -NAWiggs (Epilepsy) (Valproate), 2024 1 All studiesAll studies 1.49[0.85; 2.60]232,5180%NAWiggs (Epilepsy) (Valproate), 2024 Thomas (Valproate) (Controls unexposed, sick), 2021 Campbell (Valproate) (Controls exposed to Lamotrigine, sick), 2014 Veiby (Valproate) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2014 40.15.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.84.21.9620.000Wiggs (Epilepsy) (Valproate), 2024Thomas (Valproate) (Controls unexposed, sick), 2021Campbell (Valproate) (Controls exposed to Lamotrigine, sick), 2014Veiby (Valproate) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2014

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 12862

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed, sick controlsunexposed, sick controls 1.40[0.67; 2.94]19650%NAWiggs (Epilepsy) (Valproate), 2024 Thomas (Valproate) (Controls unexposed, sick), 2021 2 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.45[0.64; 3.31]221,8940%NAThomas (Valproate) (Controls exposed to Lamotrigine, sick), 2021 Campbell (Valproate) (Controls exposed to Lamotrigine, sick), 2014 Veiby (Valproate) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2014 30.510.01.0