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

Small for gestational age (weight)

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.
S16066
R66674
Christensen (Carbamazepine) (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: Yes 1.37 [1.17;1.60]
excluded (control group)
428/3,424   920/8,756 1,348 3,424
ref
S16019
R66499
Christensen (Carbamazepine) (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 1.25 [1.12;1.40] 428/3,424   446,267/4,467,848 446,695 3,424
ref
S15367
R63235
Bromley (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2023 Small for gestation (calculated using gender-specific scales) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No 0.28 [0.03;2.20] C
excluded (control group)
1/27   13/106 14 27
ref
S15368
R63248
Bromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Small for gestation (calculated using gender-specific scales) during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No 0.20 [0.02;1.59] C 1/27   13/80 14 27
ref
S9602
R34030
Aydin (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2020 Small for gestational age (birth weight) throughout pregnancy retrospective cohort exposed to other treatment, sick excluded Adjustment: No 2.60 [0.11;62.58] C
excluded (control group)
2/15   0/7 2 15
ref
S9603
R34040
Aydin (Carbamazepine) (Controls unexposed, sick), 2020 Small for gestational age (birth weight) throughout pregnancy retrospective cohort unexposed, sick Adjustment: No 8.60 [0.38;193.87] C 2/15   0/22 2 15
ref
S9777
R34978
Coste (Carbamazepine) (Controls unexposed, NOS) (Mixed indications), 2020 Small for gestational age (weight) during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No 1.05 [0.78;1.42] C 48/468   167,016/1,707,707 167,064 468
ref
S9761
R34852
Cohen (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2019 Small for gestational age (ICD-9 656.5, 764.0, 764.1, 764.9) early pregnancy retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: Yes 1.16 [0.59;2.26]
excluded (control group)
55/1,232   106/2,682 161 1,232
ref
S9762
R34859
Cohen (Carbamazepine) (Controls unexposed NOS) (Mixed indications), 2019 Small for gestational age (ICD-9 656.5, 764.0, 764.1, 764.9) early pregnancy retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: Yes 0.97 [0.68;1.39] 55/1,232   41,653/1,440,631 41,708 1,232
ref
S18016
R75957
Margulis (Carbamazepine) (Mixed indications), 2019 Small for gestational age (defined within the Medical Birth Register from standard growth curves based on ultra- sound-derived fetal weights for singletons only) during pregnancy (anytime or not specified) population based cohort retrospective exposed to other treatment, sick Adjustment: Yes 1.30 [0.80;2.00] -/1,821   -/1,808 - 1,821
ref
S9760
R34843
Bank (Carbamazepine) (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 1.57 [0.14;17.42] C 1/8   3/36 4 8
ref
S9743
R34762
Veiby (Carbamazepine) (Controls exposed to Lamotrigine, sick) b, 2013 Small for gestational age (SGA) birth weight during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No 3.04 [0.97;9.51] C
excluded (control group)
9/67   5/103 14 67
ref
S9745
R34781
Veiby (Carbamazepine) (Controls unexposed, disease free) b, 2013 Small for gestational age (SGA) birth weight during pregnancy (anytime or not specified) prospective cohort unexposed, disease free excluded Adjustment: Yes 2.40 [1.20;4.90]
excluded (control group)
9/67   8,017/106,899 8,026 67
ref
S9746
R34795
Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013 Small for gestational age (SGA) birth weight during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No 1.78 [0.80;3.92] C 9/67   31/386 40 67
ref
S9640
R34292
Pennell (Carbamazepine), 2012 Small for gestational age (SGA) (at birth) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick Adjustment: Yes 3.14 [0.91;10.90] 12/93   4/98 16 93
ref
S9606
R34056
Burja (Carbamazepine) (Controls unexposed, disease free), 2006 Small for date (NOS) during pregnancy (anytime or not specified) retrospective cohort (registry) unexposed, disease free excluded Adjustment: No 1.53 [0.41;5.66] C
excluded (control group)
3/19   23/211 26 19
ref
S9607
R34061
Burja (Carbamazepine) (Controls unexposed, sick), 2006 Small for date (NOS) during pregnancy (anytime or not specified) retrospective cohort (registry) unexposed, sick Adjustment: No 5.81 [0.56;60.48] C 3/19   1/32 4 19
ref
S9615
R34161
Endo (Carbamazepine) (Controls unexposed, disease free), 2004 Intrauterine growth retardation (NOS) throughout pregnancy retrospective cohort unexposed, disease free excluded Adjustment: No 2.61 [0.31;21.85] C
excluded (control group)
1/8   34/656 35 8
ref
S9616
R34176
Endo (Carbamazepine) (Controls unexposed, sick), 2004 Intrauterine growth retardation (NOS) throughout pregnancy retrospective cohort unexposed, sick Adjustment: No 0.23 [0.00;17.06] C 1/8   0/1 1 8
ref
S9651
R34339
Wide (Carbamazepine), 2000 Small for gestationnal age throughout pregnancy prospective cohort unexposed (general population or NOS) Adjustment: No Matched 0.95 [0.02;49.04] C 0/39   0/37 0 39
ref
Total 12 studies 1.20 [1.03;1.40] 655,548 7,221
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 Christensen (Carbamazepine) (All indications) (Controls unexposed, general population), 2024Christensen, 2024 1 1.25[1.12; 1.40]446,6953,42449%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Bromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023Bromley, 2023 2 0.20[0.02; 1.59]14271%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: moderateROB mesure: moderateROB reporting: low Aydin (Carbamazepine) (Controls unexposed, sick), 2020Aydin, 2020 3 8.60[0.38; 193.87]2150%ROB confusion: criticalROB selection: criticalROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Coste (Carbamazepine) (Controls unexposed, NOS) (Mixed indications), 2020Coste, 2020 4 1.05[0.78; 1.42]167,06446819%ROB confusion: criticalROB selection: moderateROB classification: criticalROB missing: moderateROB mesure: moderateROB reporting: moderate Cohen (Carbamazepine) (Controls unexposed NOS) (Mixed indications), 2019Cohen, 2019 5 0.97[0.68; 1.39]41,7081,23215%ROB confusion: moderateROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Margulis (Carbamazepine) (Mixed indications), 2019Margulis, 2019 6 1.30[0.80; 2.00]-1,82110%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Bank (Carbamazepine) (Mixed indications), 2017Bank, 2017 7 1.57[0.14; 17.42]480%ROB confusion: criticalROB selection: lowROB classification: lowROB missing: lowROB mesure: moderateROB reporting: moderate Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013Veiby, 2013 8 1.78[0.80; 3.92]40674%ROB confusion: criticalROB selection: lowROB classification: lowROB missing: moderateROB mesure: moderateROB reporting: moderate Pennell (Carbamazepine), 2012Pennell, 2012 9 3.14[0.91; 10.90]16932%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Burja (Carbamazepine) (Controls unexposed, sick), 2006Burja, 2006 10 5.81[0.56; 60.48]4190%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Endo (Carbamazepine) (Controls unexposed, sick), 2004Endo, 2004 11 0.23[0.00; 17.06]180%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Wide (Carbamazepine), 2000Wide, 2000 12 0.95[0.02; 49.04]0390%ROB confusion: criticalROB selection: lowROB classification: lowROB missing: lowROB mesure: moderateROB reporting: moderate Total (12 studies) I2 = 13% 1.20[1.03; 1.40]655,5487,2210.020.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Carbamazepine) (All indications) (Controls unexposed, general population; 2: Carbamazepine) (Epilepsy) (Controls unexposed, sick; 3: Carbamazepine) (Controls unexposed, sick; 4: Carbamazepine) (Controls unexposed, NOS) (Mixed indications; 5: Carbamazepine) (Controls unexposed NOS) (Mixed indications; 6: Carbamazepine) (Mixed indications; 7: Carbamazepine) (Mixed indications; 8: Carbamazepine) (Controls unexposed, sick) ; 9: Carbamazepine; 10: Carbamazepine) (Controls unexposed, sick; 11: Carbamazepine) (Controls unexposed, sick; 12: Carbamazepine;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.20[1.03; 1.40]655,5487,22113%NAChristensen (Carbamazepine) (All indications) (Controls unexposed, general population), 2024 Bromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Aydin (Carbamazepine) (Controls unexposed, sick), 2020 Coste (Carbamazepine) (Controls unexposed, NOS) (Mixed indications), 2020 Cohen (Carbamazepine) (Controls unexposed NOS) (Mixed indications), 2019 Margulis (Carbamazepine) (Mixed indications), 2019 Bank (Carbamazepine) (Mixed indications), 2017 Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013 Pennell (Carbamazepine), 2012 Burja (Carbamazepine) (Controls unexposed, sick), 2006 Endo (Carbamazepine) (Controls unexposed, sick), 2004 Wide (Carbamazepine), 2000 12 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.20[1.09; 1.33]655,4675,1630%NAChristensen (Carbamazepine) (All indications) (Controls unexposed, general population), 2024 Coste (Carbamazepine) (Controls unexposed, NOS) (Mixed indications), 2020 Cohen (Carbamazepine) (Controls unexposed NOS) (Mixed indications), 2019 Wide (Carbamazepine), 2000 4 unexposed, sickunexposed, sick 1.46[0.42; 5.10]6113643%NABromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Aydin (Carbamazepine) (Controls unexposed, sick), 2020 Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013 Burja (Carbamazepine) (Controls unexposed, sick), 2006 Endo (Carbamazepine) (Controls unexposed, sick), 2004 5 exposed to other treatment, sickexposed to other treatment, sick 1.45[0.95; 2.21]201,9220%NAMargulis (Carbamazepine) (Mixed indications), 2019 Bank (Carbamazepine) (Mixed indications), 2017 Pennell (Carbamazepine), 2012 3 Tags Adjustment   - No  - No 1.23[0.77; 1.98]167,12965115%NABromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Aydin (Carbamazepine) (Controls unexposed, sick), 2020 Coste (Carbamazepine) (Controls unexposed, NOS) (Mixed indications), 2020 Bank (Carbamazepine) (Mixed indications), 2017 Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013 Burja (Carbamazepine) (Controls unexposed, sick), 2006 Endo (Carbamazepine) (Controls unexposed, sick), 2004 Wide (Carbamazepine), 2000 8   - Yes  - Yes 1.22[1.01; 1.47]488,4196,57025%NAChristensen (Carbamazepine) (All indications) (Controls unexposed, general population), 2024 Cohen (Carbamazepine) (Controls unexposed NOS) (Mixed indications), 2019 Margulis (Carbamazepine) (Mixed indications), 2019 Pennell (Carbamazepine), 2012 4 MatchedMatched 0.95[0.02; 49.04]-39 -NAWide (Carbamazepine), 2000 1 All studiesAll studies 1.20[1.03; 1.40]655,5487,22113%NAChristensen (Carbamazepine) (All indications) (Controls unexposed, general population), 2024 Bromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Aydin (Carbamazepine) (Controls unexposed, sick), 2020 Coste (Carbamazepine) (Controls unexposed, NOS) (Mixed indications), 2020 Cohen (Carbamazepine) (Controls unexposed NOS) (Mixed indications), 2019 Margulis (Carbamazepine) (Mixed indications), 2019 Bank (Carbamazepine) (Mixed indications), 2017 Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013 Pennell (Carbamazepine), 2012 Burja (Carbamazepine) (Controls unexposed, sick), 2006 Endo (Carbamazepine) (Controls unexposed, sick), 2004 Wide (Carbamazepine), 2000 120.020.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-5.25.32.6350.000Christensen (Carbamazepine) (All indications) (Controls unexposed, general population), 2024Bromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023Aydin (Carbamazepine) (Controls unexposed, sick), 2020Coste (Carbamazepine) (Controls unexposed, NOS) (Mixed indications), 2020Cohen (Carbamazepine) (Controls unexposed NOS) (Mixed indications), 2019Margulis (Carbamazepine) (Mixed indications), 2019Bank (Carbamazepine) (Mixed indications), 2017Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013Pennell (Carbamazepine), 2012Burja (Carbamazepine) (Controls unexposed, sick), 2006Endo (Carbamazepine) (Controls unexposed, sick), 2004Wide (Carbamazepine), 2000

Asymetry test p-value = 0.7445 (by Egger's regression)

slope=0.1854 (0.0688); intercept=0.1350 (0.4028); t=0.3351; p=0.7445

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 9615, 9606, 9743, 9745, 9761, 9602, 15367, 16066

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.21[1.04; 1.40]663,5545,25713%NAChristensen (Carbamazepine) (All indications) (Controls unexposed, general population), 2024 Coste (Carbamazepine) (Controls unexposed, NOS) (Mixed indications), 2020 Cohen (Carbamazepine) (Controls unexposed NOS) (Mixed indications), 2019 Veiby (Carbamazepine) (Controls unexposed, disease free) b, 2013 Burja (Carbamazepine) (Controls unexposed, disease free), 2006 Endo (Carbamazepine) (Controls unexposed, disease free), 2004 Wide (Carbamazepine), 2000 7 unexposed, sick controlsunexposed, sick controls 1.46[0.42; 5.10]6113643%NABromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Aydin (Carbamazepine) (Controls unexposed, sick), 2020 Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013 Burja (Carbamazepine) (Controls unexposed, sick), 2006 Endo (Carbamazepine) (Controls unexposed, sick), 2004 5 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.38[1.19; 1.59]1,5596,6870%NAChristensen (Carbamazepine) (All indications) (Controls exposed to LTG), 2024 Bromley (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2023 Aydin (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2020 Cohen (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2019 Margulis (Carbamazepine) (Mixed indications), 2019 Bank (Carbamazepine) (Mixed indications), 2017 Veiby (Carbamazepine) (Controls exposed to Lamotrigine, sick) b, 2013 Pennell (Carbamazepine), 2012 80.510.01.0

Umbrella review (other published meta-analyses)

Published MAControlPeriodTE95% CIn exposedkI2 Veroniki a (NMA) (All indications) (Prenatal ...Veroniki a (NMA) (All indications) (Prenatal growth restriction) 1.15[0.77; 1.67]NA-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT-9 metaPregmetaPreg 1.20[1.03; 1.40]13%7,221----Christensen (Carbamazepine) (All indications) (Controls unexposed, general population), 2024 Bromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Aydin (Carbamazepine) (Controls unexposed, sick), 2020 Coste (Carbamazepine) (Controls unexposed, NOS) (Mixed indications), 2020 Cohen (Carbamazepine) (Controls unexposed NOS) (Mixed indications), 2019 Margulis (Carbamazepine) (Mixed indications), 2019 Bank (Carbamazepine) (Mixed indications), 2017 Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013 Pennell (Carbamazepine), 2012 Burja (Carbamazepine) (Controls unexposed, sick), 2006 Endo (Carbamazepine) (Controls unexposed, sick), 2004 Wide (Carbamazepine), 2000 120.510.01.0