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

Elective/induced termination of pregnancy

id	Study   Auto Moore (Controls exposed to LTG) (Valproate) (Indication NOS), 2025Moore (Controls unexposed, general pop) (Valproate) (Indication NOS), 2025Hosny (Valproate) (Controls exposed to Lamotrigine, sick), 2021Hosny (Valproate) (Controls unexposed, sick), 2021Miškov (Valproate) (Controls exposed to Lamotrigine, sick), 2016Miškov (Valproate) (Controls unexposed, disease free), 2016Miškov (Valproate) (Controls unexposed, sick), 2016Campbell (Valproate) (Controls exposed to Lamotrigine, sick), 2014	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.
S19336 R81968	Moore (Controls exposed to LTG) (Valproate) (Indication NOS), 2025	Elective termination of pregnancy	during pregnancy (anytime or not specified)	population based cohort retrospective	exposed to other treatment, sick excluded	Adjustment: No	1.45 [1.10;1.91] C excluded (control group)	82/323   351/1,846	433	323		ref
S19329 R81940	Moore (Controls unexposed, general pop) (Valproate) (Indication NOS), 2025	Elective termination of pregnancy	during pregnancy (anytime or not specified)	population based cohort retrospective	unexposed (general population or NOS)	Adjustment: Yes Matched	1.65 [1.17;2.32]	82/323   421/2,986	503	323		ref
S12882 R48684	Hosny (Valproate) (Controls exposed to Lamotrigine, sick), 2021	Induced abortion	1st trimester	prospective cohort	exposed to other treatment, sick excluded	Adjustment: No	0.07 [0.00;8.55] C excluded (control group)	0/8   0/1	0	8		ref
S12883 R48687	Hosny (Valproate) (Controls unexposed, sick), 2021	Induced abortion	1st trimester	prospective cohort	unexposed, sick	Adjustment: No	2.73 [0.05;150.47] C	0/8   0/21	0	8		ref
S9320 R32476	Miškov (Valproate) (Controls exposed to Lamotrigine, sick), 2016	Artificial abortion	during pregnancy (anytime or not specified)	prospective cohort	exposed to other treatment, sick excluded	Adjustment: No	2.15 [0.08;59.77] C excluded (control group)	0/6   1/37	1	6		ref
S9321 R32480	Miškov (Valproate) (Controls unexposed, disease free), 2016	Artificial abortion	during pregnancy (anytime or not specified)	prospective cohort	unexposed, disease free excluded	Adjustment: No	23.18 [0.42;1280.78] C excluded (control group)	0/6   0/128	0	6		ref
S9322 R32484	Miškov (Valproate) (Controls unexposed, sick), 2016	Artificial abortion	during pregnancy (anytime or not specified)	prospective cohort	unexposed, sick	Adjustment: No	0.64 [0.01;40.08] C	0/6   0/4	0	6		ref
S9333 R32566	Campbell (Valproate) (Controls exposed to Lamotrigine, sick), 2014	Induced abortions	1st trimester	prospective cohort	exposed to other treatment, sick	Adjustment: No	1.88 [0.80;4.44] C	11/1,290   10/2,198	21	1,290		ref
					Total	4 studies	1.68 [1.22;2.30]		524	1,627
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 9320, 9321, 12882, 19336