Carbamazepine (All indications)

Exposed non-exposed studies (cohort)

Study Country
Study period
Population source Exposure definition Non-exposure definition Sample size Rmk
Adab (Carbamazepine), 2004 UK
1989 - 1999
Women (n=219) with epilepsy with children (n= 375) aged between 6 months to 16 years were identified and agreed to participate. Children exposed to carbamazepine monotherapy in utero and born to mothers with epilepsy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Children unexposed to antiepileptic drugs in utero and born to mothers with epilepsy.
94 / 101 Vinten et al., 2009 is completely overlapped for the language and cognitive delay assessment (with more exposed pregnancies and better scale in this publication).
Adams (Carbamazepine), 2022 Boston, USA
1983-1993 1996-2000
Pregnant women with seizure disorders without tonic-clonic seizures during pregnancy recruited through a surveillance study conducted during the first period. Then during the second study period, subjects were identified through referrals from local neurologists, pediatricians, and obstetrician/gynecologists and through a large health maintenance organization in the Boston area. Children following gestational exposure to carbamazepine monotherapy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Children born to antiseizure medication-unexposed women with seizure disorders.
41 / 41 Pregnant women with any exposure to other agents known to be of teratogenic concern during pregnancy were excluded. Additionally, children who were born prematurely were excluded from the study.
Al Bunyan (Carbamazepine), 1999 Saudi Arabia
1985 - 1994
Pregnant epileptic patients followed up in the neurology clinics during the study period. Children whose epileptic mothers were exposed to carbamazepine monotherapy during the pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Children whose epileptic mothers did not take antiepileptic drugs during the pregnancy because their seizures were in remission and as a personal preference.
31 / 10 The control group with the data of historical controls in Saudi Arabia isn't an adequate control group.
Alsfouk (Carbamazepine), 2022 Riyadh and Jeddah, Saudi Arabia.
2005 - 2020
Pregnant women with epilepsy followed up prospectively between the study period. Epileptic mothers with carbamazepine monotherapy administered during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Epileptic mothers with lamotrigine monotherapy administered during pregnancy.
31 / 15
Alsfouk (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2021 Riyadh and Jeddah, Saudi Arabia.
1993 - 2020
Pregnant women with epilepsy followed up prospectively between the study period. Epileptic mothers with carbamazepine monotherapy administered during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Epileptic mothers with lamotrigine monotherapy administered during pregnancy.
31 / 15
Alsfouk (Carbamazepine) (Controls unexposed, sick), 2021 Riyadh and Jeddah, Saudi Arabia.
1993 - 2020
Pregnant women with epilepsy followed up prospectively between the study period. Epileptic mothers with carbamazepine monotherapy administered during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Epileptic mothers who did not take antiseizure medications during pregnancies.
31 / 30
AlSheikh (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2020 Saudi Arabia
2018 - 2019
Pregnant patients with active epilepsy admitted to the Obstetrics and Gynecology outpatient clinic and those seeking follow-up from our outpatient clinic. Patients on treatment and who had at least one seizure in the past one year. Fetuses/neonates of patients with active epilepsy who received carbamazepine monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Fetuses/neonates of patients with active epilepsy who received lamotrigine monotherapy during pregnancy.
5 / 20
AlSheikh (Carbamazepine) (Controls unexposed, sick), 2020 Saudi Arabia
2018 - 2019
Pregnant patients with active epilepsy admitted to the Obstetrics and Gynecology outpatient clinic and those seeking follow-up from our outpatient clinic. Patients on treatment and who had at least one seizure in the past one year. Fetuses/neonates of patients with active epilepsy who received carbamazepine monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Fetuses/neonates of patients with active epilepsy who did not take antiepileptic drugs during pregnancy.
5 / 8
Arkilo (Carbamazepine), 2015 USA
2006 - 2011
Women with epilepsy who were pregnant between the study period and exposed to monotherapy antiepileptic medication at any point during the pregnancy. Singleton whose epileptic mothers were exposed to carbamazepine monotherapy at any point during the pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Singleton whose epileptic mothers were exposed to lamotrigine monotherapy at any point during the pregnancy.
17 / 24
Artama (Carbamazepine), 2005 Finland
1991 - 2000
Children born during the study period (n= 2350) to women who became eligible for full reimbursement for antiepileptic drugs with epilepsy as indication diagnosed before the birth. Children whose epileptic mothers were exposed to carbamazepine as monotherapy during the first trimester of pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Children whose epileptic mothers were untreated during the first trimester of pregnancy.
805 / 939
Artama (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013 Finland
1996 - 2008
All singleton births (n = 751,139) in Finland during the study period. Births in pregnant women with epilepsy exposed to carbamazepine in monotherapy 1 month prior to pregnancy and/or any time during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Births in pregnant women with epilepsy exposed to lamotrigine in monotherapy 1 month prior to pregnancy and/or any time during pregnancy.
1084 / 173 Births with AED exposure without maternal epilepsy diagnosis were excluded from the analyses.
Artama (Carbamazepine) (Controls unexposed, disease free), 2013 Finland
1996 - 2008
All singleton births (n = 751,139) in Finland during the study period. Births in pregnant women with epilepsy exposed to carbamazepine in monotherapy 1 month prior to pregnancy and/or any time during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Births in pregnant women without epilepsy and unexposed to any antiepileptic drugs 1 month prior to pregnancy and/or any time during pregnancy.
1084 / 721948
Artama (Carbamazepine) (Controls unexposed, sick), 2013 Finland
1996 - 2008
All singleton births (n = 751,139) in Finland during the study period. Births in pregnant women with epilepsy exposed to carbamazepine in monotherapy 1 month prior to pregnancy and/or any time during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Births in pregnant women with epilepsy and unexposed to any antiepileptic drugs 1 month prior to pregnancy and/or any time during pregnancy.
1084 / 1800
Aydin (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2020 Turkey
2007 - 2017
Pregnant women with epilepsy who delivered and had follow ups at the division of perinatalogy between the study period. Pregnant women with epilepsy who received carbamazepine in monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Pregnant women with epilepsy who received lamotrigine in monotherapy during pregnancy.
15 / 7 There were no patients who had drug changes or discontinued during pregnancy.
Aydin (Carbamazepine) (Controls unexposed, sick), 2020 Turkey
2007 - 2017
Pregnant women with epilepsy who delivered and had follow ups at the division of perinatalogy between the study period. Pregnant women with epilepsy who received carbamazepine in monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Pregnant women with epilepsy with no antiepileptic drugs during pregnancy.
15 / 22 There were no patients who had drug changes or discontinued during pregnancy.
Baker (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2015 UK
2000 - 2004
Women with and without epilepsy were recruited from antenatal clinics between the study period. Children born to women with epilepsy and exposed to carbamazepine monotherapy in utero. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Children born to women with epilepsy and exposed to lamotrigine monotherapy in utero.
59 / 36 Women were excluded from recruitment if they had a severe learning disability or other chronic health condition requiring medication. Neuro-developmental disorders (as a whole) better assess in Bromley et al. 2013.
Baker (Carbamazepine) (Controls unexposed, disease free), 2015 UK
2000 - 2004
Women with and without epilepsy were recruited from antenatal clinics between the study period. Children born to women with epilepsy and exposed to carbamazepine monotherapy in utero. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Children born to women without epilepsy recruited from the same antenatal clinics of similar age, parity, and employment and residing within the same postal area.
59 / 287 Women were excluded from recruitment if they had a severe learning disability or other chronic health condition requiring medication. Neuro-developmental disorders (as a whole) better assess in Bromley et al. 2013.
Baker (Carbamazepine) (Controls unexposed, sick), 2015 UK
2000 - 2004
Women with and without epilepsy were recruited from antenatal clinics between the study period. Children born to women with epilepsy and exposed to carbamazepine monotherapy in utero. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Children born to women with epilepsy and unexposed to antiepileptic drugs in utero.
59 / 34 Women were excluded from recruitment if they had a severe learning disability or other chronic health condition requiring medication. Neuro-developmental disorders (as a whole) better assess in Bromley et al. 2013.
Ban (Carbamazepine) (Mixed indications) (Controls exposed to Lamotrigine, sick), 2015 UK
1990 - 2013
All singleton live births of mothers aged 15–44 years between the study period from a nationally representative database of UK computerised primary care records. Singleton live births of mothers exposed to carbamazepine monotherapy in first trimester of pregnancy (from four weeks before conception up to the end of 1st trimester). (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Singleton live births of mothers exposed to lamotrigine monotherapy in first trimester of pregnancy (from four weeks before conception up to the end of 1st trimester).
343 / 273 Exclusion of children of mothers with a diagnosis of diabetes or prescriptions for anti-diabetic medication before or during pregnancy. 'Among mothers prescribed AEDs in pregnancy, the majority (81%) had epilepsy'.
Ban (Carbamazepine) (Mixed indications) (Controls unexposed NOS), 2015 UK
1990 - 2013
All singleton live births of mothers aged 15–44 years between the study period from a nationally representative database of UK computerised primary care records. Singleton live births of mothers exposed to carbamazepine monotherapy in first trimester of pregnancy (from four weeks before conception up to the end of 1st trimester). (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed (general population or NOS)
Singleton live births of mothers without antiepileptic drugs in pregnancy.
343 / 257153 Exclusion of children of mothers with a diagnosis of diabetes or prescriptions for anti-diabetic medication before or during pregnancy. 'Among mothers prescribed AEDs in pregnancy, the majority (81%) had epilepsy'.
Bank (Carbamazepine) (Mixed indications), 2017 USA
2002 - 2006
Only pregnant women who were treated with antiepileptic drugs for epilepsy or bipolar disorder who chose to continue antiepileptic drugs during pregnancy and whose infants had umbilical cord antiepileptic drugs levels drawn at the time of delivery were included. Singleton pregnancies in mothers taking carbamazepine monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Singleton pregnancies in mothers taking lamotrigine monotherapy during pregnancy.
8 / 36
Barqawi (Carbamazepine), 2005 Jordan
Not specified
Pregnant women were regular attenders of the internal medicine clinic, aged 25–35 years, multiparous, with known past history of epilepsy for the last 5 years, and with no obvious cause of the disease. Pregnant women treated for epilepsy received monotherapy with carbamazepine. unexposed, sick
Pregnant epileptic women who received no drugs because they refused treatment for fear of harming the fetus.
16 / 18
Barroso (Carbamazepine), 2015 Brazil
2000 - 2010
Epileptic pregnant women with a single fetus and with a pre-gestational diagnosis who made use of antiepileptic drugs during the pregnancy were included in the study. Newborns of epileptic parturients receiving carbamazepine monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Newborns of nonepileptic parturients who had deliveries immediately before and after the delivery of epileptic parturients.
12 / 316
Battino (Carbamazepine), 1992 Milan
1977 - 1989
Epileptic patients were followed prospectively from the beginning of the pregnancy during the study period in the context of the Milan Collaborative Study on Epilepsy and Pregnancy. Offspring of epileptic mothers treated with carbamazepine monotherapy during the first trimester. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Offspring of epileptic mothers with no antiepileptic drugs administered.
61 / 9 The results for the malformations are already available in Canger 1999 (a more recent publication with a larger exposed group) except for minor malformations.
Battino (Carbamazepine), 1999 Japan, Italy and Canada
1978 - 1991
Female patient of childbearing age with epilepsy who visited clinics and who consented to be followed throughout their pregnancy. The data from three studies carried out in Canada, Japan and Italy were pooled. Infants whose epileptic mothers were exposed to carbamazepine in monotherapy until term. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Infants whose epileptic mothers were not treated with antiepileptic drugs during pregnancy.
158 / 36 Each country has its own reference standards, then the data from the different countries are pooled. Exposition period deducted from Kaneko 1999.
Bech (Carbamazepine) (Mixed indications), 2018 Denmark
2005 - 2008
All births in Denmark were identified during the study period in the Danish Medical Birth Register and only offspring of mothers exposed to antiepileptic drugs were included. Singleton offspring of mothers exposed to carbamazepine monotherapy within 90 days prior to conception to birth. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Singleton offspring of mothers exposed to antiepileptic drugs at any time but not during pregnancy.
35 / 434
Bjørk (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2018 Norway
1999 - 2008
Pregnancies registered in the MoBa cohort when information concerning use of folic acid supplements and/or plasma folate concentration during pregnancy was available. Children of women with reported epilepsy and carbamazepine monotherapy use during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Children of women with reported epilepsy and lamotrigine monotherapy use during pregnancy.
70 / 104
Bjørk (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2022 Denmark, Finland, Iceland, Norway and Sweden.
1996 - 2017
Singleton births born from mothers from five Nordic countries. Pregnacies in mothers filling at least one carbamazepine monotherapy prescription from her last menstrual period until birth. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Pregnacies in epileptic mothers filling at least one lamotrigine monotherapy prescription from her last menstrual period until birth.
3256 / 7950 Overlapping between Dreier 2023 and Bjork 2022 for ASD (2 outcomes) and also with Daugaard 2020 for Intellectual disabilities (2 outcomes), with more pregnancies in Bjork 2022 because all indications included => use of Bjork 2022 data.
Bjørk (Carbamazepine) (Controls unexposed NOS) (Mixed indications), 2022 Danemark, Finland, Iceland, Norway and Sweden.
1996 - 2017
Singleton births born from mothers from five Nordic countries. Pregnacies in mothers filling at least one carbamazepine monotherapy prescription from her last menstrual period until birth. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed (general population or NOS)
Pregnacies in mothers without antiseizure medication prescription from her last menstrual period until birth.
3256 / 4463879 Overlapping between Dreier 2023 and Bjork 2022 for ASD (2 outcomes) and also with Daugaard 2020 for Intellectual disabilities (2 outcomes), with more pregnancies in Bjork 2022 because all indications included => use of Bjork 2022 data.
Bjørk (Carbamazepine) (Controls unexposed, disease free), 2018 Norway
1999 - 2008
Pregnancies registered in the MoBa cohort when information concerning use of folic acid supplements and/or plasma folate concentration during pregnancy was available. Children of women with reported epilepsy and carbamazepine monotherapy use during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
All children of mothers without reported epilepsy unexposed to antiepileptic drugs during pregnancy.
70 / 104222
Bjørk (Carbamazepine) (Controls unexposed, sick), 2018 Norway
1999 - 2008
Pregnancies registered in the MoBa cohort when information concerning use of folic acid supplements and/or plasma folate concentration during pregnancy was available. Children of women with reported epilepsy and carbamazepine monotherapy use during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Children of women with reported epilepsy but no antiepileptic drug intake during pregnancy.
70 / 389 In this control group 127 (70.9%) reported inactive epilepsy defined as not using AEDs during the 2 years before conception or no seizures during the previous 5 years.
Bjørk (Carbamazepine) (Controls unexposed, sick) (Mixed indications), 2022 Danemark, Finland, Iceland, Norway and Sweden.
1996 - 2017
Singleton births born from mothers from five Nordic countries. Pregnacies in mothers filling at least one carbamazepine monotherapy prescription from her last menstrual period until birth. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Pregnacies in epileptic mothers without antiseizure medication prescription from her last menstrual period until birth.
3256 / 21634 Overlapping between Dreier 2023 and Bjork 2022 for ASD (2 outcomes) and also with Daugaard 2020 for Intellectual disabilities (2 outcomes), with more pregnancies in Bjork 2022 because all indications included => use of Bjork 2022 data.
Blotière (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2019 France
2011 - 2015
All pregnancies ending between the study period with at least 20 weeks of gestation Pregnancies exposed to carbamazepine monotherapy between 1 month before and 2 months after the beginning of pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Pregnancies exposed to lamotrigine monotherapy between 1 month before and 2 months after the beginning of pregnancy.
512 / 2997 Authors excluded twin pregnancies and pregnancies with a chromosomal abnormality identified. Less than 90% of exposed pregnancies have a proxy for epilepsy. Publication's OR were not kept when lower limit of the confidence interval or OR equal to 0.
Blotière (Carbamazepine) (Controls unexposed NOS) (Mixed indications), 2019 France
2011 - 2015
All pregnancies ending between the study period with at least 20 weeks of gestation Pregnancies exposed to carbamazepine monotherapy between 1 month before and 2 months after the beginning of pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed (general population or NOS)
Pregnancies with no reimbursement for antiepileptic drugs.
512 / 1875733 Twin pregnancies and pregnancies with a documented chromosomal abnormality identified excluded. Less than 90% of exposed pregnancies have a proxy for epilepsy. Publication's OR were not kept when lower limit of the confidence interval or OR equal to 0.
Borthen (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2010 Norway
1999 - 2005
All singleton births and the first child in multiple pregnancies were included (n= 365107). Miscarriages and stillbirths below week 21 were also included. Births in women who gave a past or present history of epilepsy and exposed to carbamazepine monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Births in women who gave a past or present history of epilepsy and exposed to lamotrigine monotherapy during pregnancy.
388 / 233
Borthen (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2011 Norway
1999 - 2006
During the study period, 38 483 deliveries took place at Haukeland University Hospital. Women with epilepsy using carbamazepine as monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Women with epilepsy using lamotrigine as monotherapy during pregnancy.
28 / 30 A previous publication (Borthen 2010) gives a better review of the outcomes 'caesarean', 'postpartum haemorrhage' and 'induction of labour' (adjusted OR and largest exposed population). As Veiby 2014 for the outcomes 'major malformations'.
Borthen (Carbamazepine) (Controls unexposed, disease free), 2010 Norway
1999 - 2005
All singleton births and the first child in multiple pregnancies were included (n= 365107). Miscarriages and stillbirths below week 21 were also included. Births in women who gave a past or present history of epilepsy and exposed to carbamazepine monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Births in women without a past or present history of epilepsy and unexposed to any antiepileptic drugs during pregnancy.
388 / 362302
Borthen (Carbamazepine) (Controls unexposed, disease free), 2011 Norway
1999 - 2006
During the study period, 38 483 deliveries took place at Haukeland University Hospital. Women with epilepsy using carbamazepine as monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Women without epilepsy recruited and identified from the database randomly selected among the deliveries in the same week at the same hospital as the case with epilepsy.
28 / 205 A previous publication (Borthen 2010) gives a better review of the outcomes 'caesarean', 'postpartum haemorrhage' and 'induction of labour' (adjusted OR and largest exposed population). As Veiby 2014 for the outcomes 'major malformations'
Borthen (Carbamazepine) (Controls unexposed, sick), 2010 Norway
1999 - 2005
All singleton births and the first child in multiple pregnancies were included (n= 365107). Miscarriages and stillbirths below week 21 were also included. Births in women who gave a past or present history of epilepsy and exposed to carbamazepine monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Births in women who gave a past or present history of epilepsy and unexposed to any antiepileptic drugs during pregnancy.
388 / 1863
Borthen (Carbamazepine) (Controls unexposed, sick), 2011 Norway
1999 - 2006
During the study period, 38 483 deliveries took place at Haukeland University Hospital. Women with epilepsy using carbamazepine as monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Women with epilepsy not using any antiepileptic drugs during pregnancy.
28 / 89 A previous publication (Borthen 2010) gives a better review of the outcomes 'caesarean', 'postpartum haemorrhage' and 'induction of labour' (adjusted OR and largest exposed population). As Veiby 2014 for the outcomes 'major malformations'.
Bromley (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2010 UK
2000 - 2006
Midwives in the antenatal clinics approached each woman, who gave a history of epilepsy, whatever her stage of gestation. Children born to mothers with epilepsy exposed to carbamazepine monotherapy in utero. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Children born to mothers with epilepsy exposed to lamotrigine monotherapy in utero.
48 / 34 Study design partly completed with Mawer et al., 2010. The locomotor dimension is already evaluated in Bromley et al., 2013 and language disorders/delay in Baker et al., 2015 (older children and better scales).
Bromley (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013 UK
2000 - 2004
Children born to pregnant women epileptic or not, recruited from antenatal clinics. Children born to epileptic mothers exposed to carbamazepine monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Children born to epileptic mothers exposed to lamotrigine monotherapy during pregnancy.
59 / 36 The children or mothers who had conditions likely to influence neurodevelopmental outcome were excluded. The result for autism spectrum disorders is an update compares to the preliminary findings presented in Bromley 2008.
Bromley (Carbamazepine) (Controls unexposed, disease free), 2010 UK
2000 - 2006
Midwives in the antenatal clinics approached each woman, who gave a history of epilepsy, whatever her stage of gestation. Children born to mothers with epilepsy exposed to carbamazepine monotherapy in utero. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Children born to mothers without epilepsy were recruited from the same antenatal clinics.
48 / 230 Study design partly completed with Mawer et al., 2010. The locomotor dimension is already evaluated in Bromley et al., 2013 and language disorders/delay in Baker et al., 2015 (older children and better scales).
Bromley (Carbamazepine) (Controls unexposed, disease free), 2013 UK
2000 - 2004
Children born to pregnant women epileptic or not, recruited from antenatal clinics. Children born to epileptic mothers exposed to carbamazepine monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Children born to women without epilepsy.
59 / 285 The children or mothers who had conditions likely to influence neurodevelopmental outcome were excluded. The result for autism spectrum disorders is an update compares to the preliminary findings presented in Bromley 2008.
Bromley (Carbamazepine) (Controls unexposed, sick), 2010 UK
2000 - 2006
Midwives in the antenatal clinics approached each woman, who gave a history of epilepsy, whatever her stage of gestation. Children born to mothers with epilepsy exposed to carbamazepine monotherapy in utero. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Children born to mothers with epilepsy not exposed to antiepileptic drugs in utero.
48 / 27 Study design partly completed with Mawer et al., 2010. The locomotor dimension is already evaluated in Bromley et al., 2013 and language disorders/delay in Baker et al., 2015 (older children and better scales).
Bromley (Carbamazepine) (Controls unexposed, sick), 2013 UK
2000 - 2004
Children born to pregnant women epileptic or not, recruited from antenatal clinics. Children born to epileptic mothers exposed to carbamazepine monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Children were born to women with epilepsy who were not taking medication during their pregnancy.
59 / 34 The children or mothers who had conditions likely to influence neurodevelopmental outcome were excluded. The result for autism spectrum disorders is an update compares to the preliminary findings presented in Bromley 2008.
Bromley (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2023 United Kingdom
2014 - 2016
Pregnant women with epilepsy, of <21 weeks gestation, recruited from 21 hospitals in the UK (across the North West and North East of England and from Northern Ireland). Pregnant women with epilepsy exposed to Carbamazepine during pregnancy. exposed to other treatment, sick
Pregnant women with epilepsy exposed to Lamotrigine during pregnancy.
27 / 106
Bromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 United Kingdom
2014 - 2016
Pregnant women with epilepsy, of <21 weeks gestation, recruited from 21 hospitals in the UK (across the North West and North East of England and from Northern Ireland). Pregnant women with epilepsy exposed to Carbamazepine during pregnancy. unexposed, sick
Pregnant women with epilepsy and with no antiseizure medication.
27 / 80
Burja (Carbamazepine) (Controls unexposed, disease free), 2006 Slovenia
1998 - 2002
Newborns and their mothers who gave birth at the Maribor Department of Obstetric and Perinatology during the study period. Newborn in women diagnosed as having epilepsy who had taken carbamazepine in monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Newborn in a randomized sample of pregnant women who had received no prescription at all (with the only diagnosis 'vaginal delivery') in the same period.
19 / 211
Burja (Carbamazepine) (Controls unexposed, sick), 2006 Slovenia
1998 - 2002
Newborns and their mothers who gave birth at the Maribor Department of Obstetric and Perinatology during the study period. Newborn in women diagnosed as having epilepsy who had taken carbamazepine in monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Newborn in women diagnosed as having epilepsy who didn't take antiepileptic drugs during pregnancy.
19 / 32
Campbell (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2014 UK and Ireland
1996 - 2012
Pregnant women with epilepsy, whether or not they were taking an antiepileptic drug, either in monotherapy or polytherapy, and who were referred to the register before the outcome of the pregnancy was known. Infants of women with epilepsy exposed to carbamazepine in monotherapy during the first trimester. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Infants of women with epilepsy exposed to lamotrigine in monotherapy during the first trimester.
1718 / 2198 Morrow et al., 2009 specific malformations results and major malformations results from Morrow et al., 2006 and Campbell et al., 2013 are completely overlapped by this publication. Study design was partly completed with Morrow 2006.
Campbell (Carbamazepine) (Controls unexposed, sick), 2014 UK and Ireland
1996 - 2012
Pregnant women with epilepsy, whether or not they were taking an antiepileptic drug, either in monotherapy or polytherapy, and who were referred to the register before the outcome of the pregnancy was known. Infants of women with epilepsy exposed to carbamazepine in monotherapy during the first trimester. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Infants of women with epilepsy on no antiepileptic drugs during pregnancy.
1718 / 541 Study design was partly completed with Morrow 2006. Morrow et al., 2006 major malformations results are completely overlapped by this publication with a larger exposed group.
Canger (Carbamazepine), 1999 Italy
1977 - 1996
517 women with epilepsy reffered to the study mainly from the Milan metropolitan and suburban areas or other Italian regions. They were followed up during the preconceptional period and/or from the beginning of pregnancy. Infants of epileptic mothers exposed to carbamazepine monotherapy during the first trimester. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Infants of epileptic mothers unexposed to antiepileptic drugs during pregnancy.
113 / 25 Only the first pregnancies of each of the 517 women were included in the analysis.
Cassina (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2013 Italy
2000 - 2008
695 pregnant epileptic or non-epileptic women exposed to antiepileptic drugs therapy had been registered during the study period. Children whose epileptic or non-epileptic mothers were treated with carbamazepine in monotherapy between the 5th and the 14th week after their last menstrual period. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Children whose epileptic or non-epileptic mothers were treated with lamotrigine in monotherapy between the 5th and the 14th week after their last menstrual period.
142 / 57 Chromosomal anomalies and genetic syndromes were excluded. Less than 90% of women are treated with Carbamazepine or Lamotrigine for epilepsy.
Cassina (Carbamazepine) (Controls unexposed, disease free) (Mixed indications), 2013 Italy
2000 - 2008
695 pregnant epileptic or non-epileptic women exposed to antiepileptic drugs therapy had been registered during the study period. Children whose epileptic or non-epileptic mothers were treated with carbamazepine in monotherapy between the 5th and the 14th week after their last menstrual period. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Healthy pregnant women randomly selected among patients who contacted the Teratology Information Services during their pregnancy with regard to exposure to agents known not to be teratogenic (i.e. paracetamol, hair dying, etc.) during a similar time frame.
142 / 867 Chromosomal anomalies and genetic syndromes were excluded. Less than 90% of women are treated with Carbamazepine for epilepsy.
Charlton (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2011 UK
1990 - 2006
Mother-baby pairs whose mothers are identified as having epilepsy and who were, or had been, permanently registered at a general practitioner practice considered by the database. Infants of mother-baby pairs who had carbamazepine monotherapy exposure during the first trimester. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Infants of mother-baby pairs who had lamotrigine monotherapy exposure during the first trimester.
311 / 98 The results obtained by the UK Epilepsy and Pregnancy Register are already obtained in the publication of Morrow 2006, thus, only those extracted from the UK General Practice Research Database are implemented here.
Charlton (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2017 UK
2000 - 2006
All pregnancies to women with epilepsy were identified in the database, where the pregnancy ended in a live delivery between the study period. Mother–child pairs where the mother had epilepsy and received carbamazepine monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Mother–child pairs where the mother had epilepsy and received lamotrigine monotherapy during pregnancy.
148 / 122 The results obtained by the Liverpool and Manchester Neurodevelopment Group are already obtained by the publication of Bromley 2013, thus, only those extracted from the UK Clinical Practice Research Datalink are implemented here.
Charlton (Carbamazepine) (Controls unexposed, disease free), 2017 UK
2000 - 2006
All pregnancies to women with epilepsy were identified in the database, where the pregnancy ended in a live delivery between the study period. And subsequently matched mother–child pairs without epilepsy from the same database. Mother–child pairs where the mother had epilepsy and received carbamazepine monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Mother–child pairs where the mother did not meet the epilepsy criteria and had not been prescribed an antiepileptic drug at any time prior to her child turning age 6 years.
148 / 6048 The results obtained by the Liverpool and Manchester Neurodevelopment Group are already obtained by the publication of Bromley 2013, thus, only those extracted from the UK Clinical Practice Research Datalink are implemented here.
Charlton (Carbamazepine) (Controls unexposed, sick), 2011 UK
1990 - 2006
Mother-baby pairs whose mothers are identified as having epilepsy and who were, or had been, permanently registered at a general practitioner practice considered by the database. Infants of mother-baby pairs who had carbamazepine monotherapy exposure during the first trimester. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Infants of mother-baby pairs who had no antiepleptic drug exposure during the first trimester.
311 / 902 The results obtained by the UK Epilepsy and Pregnancy Register are already obtained in the publication of Morrow 2006, thus, only those extracted from the UK General Practice Research Database are implemented here.
Charlton (Carbamazepine) (Controls unexposed, sick), 2017 UK
2000 - 2006
All pregnancies to women with epilepsy were identified in the database, where the pregnancy ended in a live delivery between the study period. Mother–child pairs where the mother had epilepsy and received carbamazepine monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Mother–child pairs where the mother had epilepsy and no antiepileptic drug exposure during pregnancy.
148 / 472 The results obtained by the Liverpool and Manchester Neurodevelopment Group are already obtained by the publication of Bromley 2013, thus, only those extracted from the UK Clinical Practice Research Datalink are implemented here.
Christensen (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Indications NOS), 2013 Denmark
1996 - 2006
All children born alive in Denmark during the study period. Children whose mothers have been exposed to carbamazepine in monotherapy during the exposure window defined from 30 days before the estimated day of conception to the day of birth. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Children whose mothers have been exposed to lamotrigine in monotherapy during the exposure window defined from 30 days before the estimated day of conception to the day of birth.
386 / 647 Indications not specified. Overlapping: For ASD diagnosis/risk : data of Christensen 2019 included in Bjork 2022 because longer study period and 5 countries => use of Bjork 2022 data.
Christensen (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2015 Denmark
1997 - 2008
All singleton live born children in Denmark during the study period. Children whose mothers have been exposed to carbamazepine in monotherapy during the exposure window defined from 30 days before the estimated day of conception to the day prior to birth. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Children whose mothers have been exposed to lamotrigine in monotherapy during the exposure window defined from 30 days before the estimated day of conception to the day prior to birth.
344 / 875 76% of all exposed mothers have epilepsy.
Christensen (Carbamazepine) (Controls unexposed NOS) (Indications NOS), 2013 Denmark
1996 - 2006
All children born alive in Denmark during the study period. Children whose mothers have been exposed to carbamazepine in monotherapy during the exposure window defined from 30 days before the estimated day of conception to the day of birth. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed (general population or NOS)
Children whose mothers haven't been exposed to carbamazepine during the exposure window defined from 30 days before the estimated day of conception to the day of birth.
386 / 655153 Indications not specified. Overlapping: For ASD diagnosis/risk : data of Christensen 2019 included in Bjork 2022 because longer study period and 5 countries => use of Bjork 2022 data.
Christensen (Carbamazepine) (Controls unexposed NOS) (Mixed indications), 2015 Denmark
1997 - 2008
All singleton live born children in Denmark during the study period. Children whose mothers have been exposed to carbamazepine in monotherapy during the exposure window defined from 30 days before the estimated day of conception to the day prior to birth. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed (general population or NOS)
Children whose mothers haven't been exposed to antiepileptic drugs.
344 / 674115 76% of all exposed mothers have epilepsy.
Christensen (Carbamazepine) (Controls unexposed, sick) (Mixed indications), 2015 Denmark
1997 - 2008
All singleton live born children in Denmark during the study period. Children whose mothers have been exposed to carbamazepine in monotherapy during the exposure window defined from 30 days before the estimated day of conception to the day prior to birth. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Children whose epileptic mothers haven't been exposed to antiepileptic drugs.
344 / 5261 76% of all exposed mothers have epilepsy.
Cohen (Carbamazepine), 2011 UK and USA
1999 - 2004
Pregnant women with epilepsy who were taking a single antiepileptic drug in one of the 25 centers across UK and USA. Infants of women exposed to carbamazepine in monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Infants of women exposed to lamotrigine in monotherapy during pregnancy.
61 / 76 A nonexposed control group was not included. Total number of children exposed to each antiepileptic drugs is not specified, so the number of mothers is reported instead.
Cohen (Carbamazepine), 2013 USA and UK
1999 - 2004
Pregnant women (n=192) with epilepsy who were taking a single antiepileptic drug in one of the 25 epilepsy centers across UK and USA. Infants of women exposed to carbamazepine in monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Infants of women exposed to lamotrigine in monotherapy during pregnancy.
53 / 61 A nonexposed control group was not included.
Cohen (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2019 USA
2000 - 2010
Deliveries during the study period in mothers 12-55 years of age with continuous enrollment from 3 months before pregnancy until 1 month after delivery. They are linked to live born infants in the database. Pregnancies in women with at least one dispensed prescription for carbamazepine monotherapy (no other mood stabilizers or other anticonvulsants) in the first 20 weeks of pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Pregnancies in women with at least one dispensed prescription for lamotrigine monotherapy (no other mood stabilizers or other anticonvulsants) in the first 20 weeks of pregnancy.
1232 / 2682 Authors excluded deliveries with a major congenital malformation (identified by ICD-9).
Cohen (Carbamazepine) (Controls unexposed NOS) (Mixed indications), 2019 USA
2000 - 2010
Deliveries during the study period in mothers 12-55 years of age with continuous enrollment from 3 months before pregnancy until 1 month after delivery. They are linked to live born infants in the database. Pregnancies in women with at least one dispensed prescription for carbamazepine monotherapy (no other mood stabilizers or other anticonvulsants) in the first 20 weeks of pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed (general population or NOS)
Pregnancies in patients with no dispensing of lithium or any anticonvulsant (including those not used as mood stabilizers) from 3 months before pregnancy until 20 weeks of gestation.
1232 / 1440631 Authors excluded deliveries with a major congenital malformation (identified by ICD-9).
Cohen (Carbamazepine) (Mixed indications) (Controls exposed to LTG), 2023 Denmark, Finland, Iceland, Norway, and Sweden
1996 - 2020
All pregnancies in the general population, including singleton and multiple births, live births and stillbirths, with a gestational age of at least 22 weeks occurring during the study period (terminations of pregnancy for fetal anomaly (TOPFAs) recorded in Norway, Finland and Denmark but not in Sweden or Iceland). Pregnancies in which the mother had filled one or more prescriptions of carbamazepine ([ATC] code N03AF01) monotherapy during the first trimester. exposed to other treatment, sick
Pregnancies in which the mother had filled one or more prescriptions of lamotrigine monotherapy during the first trimester.
2674 / 8339 Main carbamazepine indications: 89% epilepsy; 8% unknown. Overlapping: Cohen 2023 included totally Christensen 2021 (excluded); and for Kallen 2013 and Veiby 2014 => less of 50% of overlapping => the 2 studies were kept.
Cohen (Carbamazepine) (Mixed indications) (Controls unexposed, NOS), 2023 Denmark, Finland, Iceland, Norway, and Sweden
1996 - 2020
All pregnancies in the general population, including singleton and multiple births, live births and stillbirths, with a gestational age of at least 22 weeks occurring during the study period (terminations of pregnancy for fetal anomaly (TOPFAs) recorded in Norway, Finland and Denmark but not in Sweden or Iceland). Pregnancies in which the mother had filled one or more prescriptions of carbamazepine ([ATC] code N03AF01) monotherapy during the first trimester. unexposed (general population or NOS)
Pregnancies in which the mother had not filled a prescription for any Antiseizure medication (ATC code N03A) from 90 days before LMP to the end of the first trimester.
2674 / 4866362 Main carbamazepine indications: 89% epilepsy; 8% unknown. Overlapping: Cohen 2023 included totally Christensen 2021 (excluded); and for Kallen 2013 and Veiby 2014 => less of 50% of overlapping => the 2 studies were kept.
Coste (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2020 France
2011 - 2014
All liveborn singleton children born during the study period. The mother had to be covered by the national health insurance general scheme for salaried workers and to have had at least one health expenditure reimbursement over the 2 years preceding the onset of pregnancy. Children born from mothers exposed to carbamazepine monotherapy indicated for the treatment of epilepsy and bipolar disorder with at least one dispensing between the beginning of the month preceding onset of pregnancy and its end. (Subgroup of exposure among the whole exposed group in the study). exposed to other treatment, sick
Children born from mothers exposed to lamotrigine monotherapy for mixed indications during pregnancy.
502 / 2916 Children with a diagnosis of brain malformation (ICD-10 codes Q00 to Q04 and Q05.0 to Q05.4) during their stay in the maternity unit are excluded. Results are extracted from Blotière et al. 2020 because they reported aOR for vs LTG.
Coste (Carbamazepine) (Controls unexposed, NOS) (Mixed indications), 2020 France
2011 - 2014
All liveborn singleton children born during the study period. The mother had to be covered by the national health insurance general scheme for salaried workers and to have had at least one health expenditure reimbursement over the 2 years preceding the onset of pregnancy. Children born from mothers exposed to carbamazepine monotherapy indicated for the treatment of epilepsy and bipolar disorder with at least one dispensing between the beginning of the month preceding onset of pregnancy and its end. (Subgroup of exposure among the whole exposed group in the study). unexposed (general population or NOS)
Children born from mothers not exposed to either antiepileptic drug or any drugs for bipolar disorder during pregnancy.
468 / 1707707 Children with a diagnosis of brain malformation (ICD-10 codes Q00 to Q04 and Q05.0 to Q05.4) during their stay in the maternity unit are excluded.
Cummings (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2011 Northern Ireland
2002 - 2005
Infants and children born to mothers with epilepsy taking one of three antiepileptic drugs (lamotrigine, sodium valproate or carbamazepine) as monotherapy throughout pregnancy and enrolled on the UK Epilepsy and Pregnancy Register. And control children are identified from the Child Health System database. Children born to epileptic mothers taking carbamazepine as monotherapy throughout pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Children born to epileptic mothers taking lamotrigine as monotherapy throughout pregnancy.
49 / 35 Women who were taking any other prescribed medication other than folic acid or iron supplements are excluded. The method for exposition measure isn't recalled here but it's always the same for this register.
Cummings (Carbamazepine) (Controls unexposed, disease free), 2011 Northern Ireland
2002 - 2005
Infants and children born to mothers with epilepsy taking one of three antiepileptic drugs (lamotrigine, sodium valproate or carbamazepine) as monotherapy throughout pregnancy and enrolled on the UK Epilepsy and Pregnancy Register. And control children are identified from the Child Health System database. Children born to epileptic mothers taking carbamazepine as monotherapy throughout pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Children born to healthy women not taking prescribed medication other than folic acid or iron supplements during pregnancy.
49 / 44 Women who were taking any other prescribed medication other than folic acid or iron supplements are excluded. The method for exposition measure isn't recalled here but it's always the same for this register.
D'Souza (Carbamazepine) (Controls unexposed, disease free), 1991 UK
1980 - 1982
A group of pregnant mothers each of whom gave a history of grand mal epilepsy and who were referred to the antenatal clinic during the study period. Infants born to epileptic mothers treated with carbamazepine alone throughout pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Infants born to mothers without epilepsy not taking any drugs regularly.
3 / 62
D'Souza (Carbamazepine) (Controls unexposed, sick), 1991 UK
1980 - 1982
A group of pregnant mothers each of whom gave a history of grand mal epilepsy and who were referred to the antenatal clinic during the study period. Infants born to epileptic mothers treated with carbamazepine alone throughout pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Infants whose mothers had a history of epilepsy but received no drugs during pregnancy.
3 / 8
Dean (Carbamazepine), 2002 Scotland
1976 - 2000
Children of mothers taking antiepileptic drugs in pregnancy during the study period were ascertained from hospital obstetric records. Children whose mothers took carbamazepine monotherapy in pregnancy and continued beyond the first trimester. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Sibs of exposed cases not exposed to antiepileptic drugs in utero. Either the mothers had epilepsy or the child was born before epilepsy developed.
70 / 38 The data for major congenital malformations include all pregnancies surviving into the second trimester. The vast majority of the mothers were treated for epilepsy. Developmental delay is already assessed in Dean et al. 2007.
Dean (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2007 Scotland
1976 - 2002
Children of mothers who were prescribed antiepileptic drugs during a pregnancy between the study period were identified from hospital records. Children whose epileptic mothers were exposed to carbamazepine monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Children whose epileptic mothers were exposed to lamotrigine monotherapy during pregnancy.
77 / 4 A previous publication (Dean 2002) gives a better review of the major malformations.
Dean (Carbamazepine) (Controls unexposed, sick), 2007 Scotland
1976 - 2002
Children of mothers who were prescribed antiepileptic drugs during a pregnancy between the study period were identified from hospital records. Children whose epileptic mothers were exposed to carbamazepine monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Children whose epileptic mothers were not exposed during pregnancy.
77 / 46 A previous publication (Dean 2002) gives a better review of the major malformations.
Deshmukh (Carbamazepine), 2016 North America and Canada
1997 - 2010
Pregnant women with epilepsy who had prospectively enrolled in the registry while taking LTG, VPA, or CBZ as monotherapy to suppress seizures throughout pregnancy, and whose exposed children were 3- to 6-years-old.. Children of women who used carbamazepine as monotherapy throughout pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Children of women who used lamotrigine as monotherapy throughout pregnancy.
97 / 104 Study design completed with cited source [28]. Major malformation rate of this sample is already assessed in Hernández-Díaz 2012.
Diav-Citrin (Carbamazepine), 2001 Israel
1989 - 1999
Pregnant women who contacted (directly or through their healthcare provider) the Teratology Information Service regarding gestational carbamazepine exposure during the study period. Pregnant women with at least first trimester exposure to carbamazepine for an epileptic indication in monotherapy. unexposed (general population or NOS)
Callers women who had been counselled (over a similar timeframe) during pregnancy in regard to exposures known to be nonteratogenic or foetotoxic.
108 / 210
Díaz-Romero (Carbamazepine), 1999 Mexico
1993 - 1996
Full-term eutrophic newborns of epileptic mothers who attended the Epilepsy Clinic of the National Institute of Perinatology, a third-level gyneco-obstetric center in Mexico City during the study period. Full-term eutrophic newborns of epileptic mothers exposed to only carbamazepine during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Offspring of epileptic women without seizures during pregnancy and without exposure to any drug.
26 / 8 All newborns in the intensive care unit, and those with congenital malformations with a different specific recognizable etiology were excluded.
Dreier (Carbamazepine), 2021 Danemark, Finland, Iceland, Norway, Sweden
1996 (depends)-2017
Live-born singleton children from women with epilepsy in five Nordic countries. Offspring of women with prescription for carbamazepine monotherapy from 90 days before pregnancy to birth. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Offspring of women with epilepsy not using antiseizure medication in pregnancy.
2650 / -9 Unknown number in the exposed and unexposed group (abstract).
Dreier (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2023 Denmark, Finland, Iceland, Norway, and Sweden.
1996 - 2017
Live-born singleton children of mothers with epilepsy in Denmark (1997-2017), Finland (1996- 2016), Iceland (2004-2017), Norway (2005-2017), and Sweden (2006-2017). Children prenatally exposed to Carbamazepine monotherapy, i.e whose mother had redeemed 1 or more prescriptions during the exposure window, which was defined as 30 days before the first day of the last menstrual period (estimated using gestational age in days at birth) until the date of birth. exposed to other treatment, sick
Children prenatally exposed to Lamotrigine monotherapy, i.e whose mother had redeemed 1 or more prescriptions during the exposure window, which was defined as 30 days before the first day of the last menstrual period (estimated using gestational age in days at birth) until the date of birth.
2665 / 5288 Overlapping: Dreier 2023 and Bjork 2022 for ASD (2 outcomes) and Intellectual disabilities (2 outcomes), with more pregnancies in Bjork 2022 because all indications included => use of Bjork 2022 data. Christensen 2019 totally included in Dreier 2023.
Dreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Denmark, Finland, Iceland, Norway, and Sweden.
1996 - 2017
Live-born singleton children of mothers with epilepsy in Denmark (1997-2017), Finland (1996- 2016), Iceland (2004-2017), Norway (2005-2017), and Sweden (2006-2017). Children prenatally exposed to Carbamazepine monotherapy, i.e whose mother had redeemed 1 or more prescriptions during the exposure window, which was defined as 30 days before the first day of the last menstrual period (estimated using gestational age in days at birth) until the date of birth. unexposed, sick
Children not prenatally exposed to antiseizure medication.
2665 / 22203 Overlapping: Dreier 2023 and Bjork 2022 for ASD (2 outcomes) and Intellectual disabilities (2 outcomes), with more pregnancies in Bjork 2022 because all indications included => use of Bjork 2022 data. Christensen 2019 totally included in Dreier 2023.
Endo (Carbamazepine) (Controls unexposed, disease free), 2004 Japan
1991 - 2000
Newborn of mothers with epilepsy at Yokohama City University Hospital during the study period and total deliveries excluding epilepsy cases of 1991 and 1992 at the same hospital. Newborns of epileptic mothers who take carbamazepine monotherapy for epilepsy throughout pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Newborns of nonepileptic mothers.
8 / 656 30 (83.3%) cases of 36 pregnancies continued taking drugs throughout pregnancy. Three (8.3%) patients discontinued after week 13 of pregnancy. Some results do not coincide between table 1 and table 2 and are therefore not reported.
Endo (Carbamazepine) (Controls unexposed, sick), 2004 Japan
1991 - 2000
Newborn of mothers with epilepsy at Yokohama City University Hospital during the study period and total deliveries excluding epilepsy cases of 1991 and 1992 at the same hospital. Newborns of epileptic mothers who take carbamazepine monotherapy for epilepsy throughout pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Newborns of epileptic mothers who had not taken any antiepileptic drugs.
8 / 1 30 (83.3%) cases of 36 pregnancies continued taking drugs throughout pregnancy. Three (8.3%) patients discontinued after week 13 of pregnancy. Some results do not coincide between table 1 and table 2 and are therefore not reported.
Eriksson (Carbamazepine), 2005 Finland
1989 - 2000
Women with epilepsy who had given birth between the study period in the area of the Kuopio University Hospital. Pregnancies in which the mother had used carbamazepine during conception and throughout pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Pregnancies in which the mother reported having previous history of epilepsy but had not needed antiepileptic drugs during pregnancy.
13 / 13 The period of exposure is specified in Viinikainen 2006. The cognitive delay of this sample at the same age is already assessed in Viinikainen 2006, thus, not reported here.
Forsberg (Carbamazepine) (Controls unexposed NOS), 2011 Sweden
1973 - 1986
Using the Swedish Medical Birth Register, deliveries among women with epilepsy were identified between the study period. Children identified with maternal epilepsy who had been exposed to carbamazepine monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed (general population or NOS)
All other children born in Sweden between the study period.
243 / 1307083 These analyses were made after exclusion of children with a diagnosis of a congenital malformation.
Forsberg (Carbamazepine) (Controls unexposed, sick), 2011 Sweden
1973 - 1986
Using the Swedish Medical Birth Register, deliveries among women with epilepsy were identified between the study period. Children identified with maternal epilepsy who had been exposed to carbamazepine monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Children identified with maternal epilepsy but no use of antiepileptic drug.
243 / -9 These analyses were made after exclusion of children with a diagnosis of a congenital malformation. Number of children identified with maternal epilepsy but no use of antiepileptic drug not specified.
Gaily (Carbamazepine) (Controls unexposed, disease free), 2004 Finland
1989 - 1994
All 306 liveborn children (including siblings) born at Helsinki University Hospital during the study period to mothers with a history of seizures or epilepsy. Children of mothers with epilepsy exposed to carbamazepine monotherapy during the second half of the pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
The next child born at the same hospital to a nonepileptic mother and unexposed to antiepileptic drugs.
86 / 141
Gaily (Carbamazepine) (Controls unexposed, sick), 2004 Finland
1989 - 1994
All 306 liveborn children (including siblings) born at Helsinki University Hospital during the study period to mothers with a history of seizures or epilepsy. Children of mothers with epilepsy exposed to carbamazepine monotherapy during the second half of the pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Children of mothers with epilepsy with no drug exposure.
86 / 45
Hernández-Díaz (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2012 North America and Canada
1997 - 2011
Pregnant women who are taking an antiepileptic drug for any reason and had a liveborn infant, a stillborn infant, or a pregnancy terminated because of a fetal abnormality and enrolled as 'pure' or 'traditional' enrollees. Infants of pregnant women who used carbamazepine for epileptic indication as monotherapy, during the first 4 lunar months after the last menstrual period (equal 16 weeks of gestation). (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Infants of pregnant women who used lamotrigine for mixed indications as monotherapy, during the first 4 lunar months after the last menstrual period (equal 16 weeks of gestation).
1033 / 1562 Total congenital malformations results are completely overlapped by the update on the registry website. Less than 90% of women are taking Lamotrigine for epilepsy.
Hernández-Díaz (Carbamazepine) (Controls unexposed, disease free), 2012 North America and Canada
1997 - 2011
Pregnant women who are taking an antiepileptic drug for any reason and had a liveborn infant, a stillborn infant, or a pregnancy terminated because of a fetal abnormality and enrolled as 'pure' or 'traditional' enrollees. Infants of pregnant women who used carbamazepine for epileptic indication as monotherapy, during the first 4 lunar months after the last menstrual period (equal 16 weeks of gestation). (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Infants of pregnant women, not taking an antiepileptic drug and without epilepsy, who were recruited from among the friends and family members of the enrolled women taking an antiepileptic drug.
1033 / 442 Total congenital malformations results are completely overlapped by the update on the registry website.
Holmes (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2011 North America and Canada
1997 - 2011
Pregnant women who are taking an antiepileptic drug for any reason and had a liveborn infant, a stillborn infant, an infant who died in the first 28 days of life or an elective termination of pregnancy and enrolled before they have had any prenatal testing. Infants of pregnant women who used carbamazepine as monotherapy, during the first 4 lunar months after the last menstrual period (equal 16 weeks of gestation). (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Infants of pregnant women who used lamotrigine as monotherapy, during the first 4 lunar months after the last menstrual period (equal 16 weeks of gestation).
674 / 1118 Less than 90% of women are taking Lamotrigine for epilepsy. Major malformations results are already assessed in Hernández-Díaz 2012 with more exposed pregnancies.
Holmes (Carbamazepine) (Controls unexposed, disease free), 2001 United States
1986 - 1993
128,049 pregnant women at delivery who gave birth to singleton in the labor and delivery suites during the study period. Infants exposed in utero to carbamazepine in monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Infants unexposed in utero to any antiepileptic drugs born to women with no history of seizure and closest in time from the corresponding exposed children.
58 / 508 9% are exposed for other indications (not specified per type of AED).
Holmes (Carbamazepine) (Controls unexposed, disease free), 2011 North America and Canada
1997 - 2011
Pregnant women who are taking an antiepileptic drug for any reason and had a liveborn infant, a stillborn infant, an infant who died in the first 28 days of life or an elective termination of pregnancy and enrolled before they have had any prenatal testing. Infants of pregnant women who used carbamazepine as monotherapy, during the first 4 lunar months after the last menstrual period (equal 16 weeks of gestation). (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Infant of pregnant women not taking an antiepileptic drugs and without epilepsy who had been recruited among the friends and relatives of antiepileptic drugs-exposed participants.
674 / 209 Major malformations results are already assessed in Hernández-Díaz 2012 with more exposed pregnancies.
Holmes (Carbamazepine) (Controls unexposed, sick), 2001 United States
1986 - 1993
128,049 pregnant women at delivery who gave birth to singleton in the labor and delivery suites during the study period. Infants exposed in utero to carbamazepine in monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Infants unexposed in utero to any antiepileptic drugs born to women with a history of seizure.
58 / 98 9% are exposed for other indications (no specified per type of AED).
Hosny (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2021 Egypt
2018 - 2020
Pregnant women with epilepsy enrolled within the first trimester recruited from the epilepsy outpatient clinic and several private epilepsy centers during the study period. Pregnant women with epilepsy on carbamazepine monotherapy during the first trimester. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Pregnant women with epilepsy on lamotrigine monotherapy during the first trimester.
31 / 1 Each woman had one pregnancy during the study period. The correct figures were sent by the authors.
Hosny (Carbamazepine) (Controls unexposed, sick), 2021 Egypt
2018 - 2020
Pregnant women with epilepsy enrolled within the first trimester recruited from the epilepsy outpatient clinic and several private epilepsy centers during the study period. Pregnant women with epilepsy on carbamazepine monotherapy during the first trimester. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Pregnant women with epilepsy with no treatment during the first trimester.
31 / 21 Each woman had one pregnancy during the study period. The correct figures were sent by the authors.
Huber-Mollema (Carbamazepine), 2019 The Netherlands
2015 - 2018
Children of mothers with epilepsy identified from the EURAP‐NL database. Recruitment of women ideally occurs within the first 16 weeks of pregnancy. Children age between 6 years and 7 years 11 months of mothers with epilepsy exposed to carbamazepine monotherapy starting before conception and continuing during the entire pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Children age between 6 years and 7 years 11 months of mothers with epilepsy exposed to lamotrigine monotherapy starting before conception and continuing during the entire pregnancy.
37 / 88 The method for measuring exposure is not specified, although the EURAP registry method was thought to be used.
Husebye (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2020 Norway
1999 - 2008
Children of mothers with and without epilepsy included in the MoBa cohort. Children of mothers with epilepsy exposed to carbamazepine monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Children of mothers with epilepsy exposed to lamotrigine monotherapy during pregnancy.
72 / 112
Husebye (Carbamazepine) (Controls unexposed, disease free), 2020 Norway
1999 - 2008
Children of mothers with and without epilepsy included in the MoBa cohort. Children of mothers with epilepsy exposed to carbamazepine monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Children of mothers without epilepsy.
72 / 113674
Husebye (Carbamazepine) (Controls unexposed, sick), 2020 Norway
1999 - 2008
Children of mothers with and without epilepsy included in the MoBa cohort. Children of mothers with epilepsy exposed to carbamazepine monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Children of mothers with epilepsy unexposed to antiepileptic durgs during pregnancy.
72 / 388 For this comparison group, results are only available according to folic acid intake.
Hvas (Carbamazepine) (Controls unexposed, disease free), 2000 Denmark
1989 - 1997
Singleton pregnancies in Danish-speaking women who attended for antenatal care and delivered at Aarhus University Hospital during the study period. All women who reported chronic disease other than epilepsy were excluded. Children of women with epilepsy exposed to carbamazepine monotherapy during the first trimester of pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Children of women without chronic disease.
37 / 24094
Hvas (Carbamazepine) (Controls unexposed, sick), 2000 Denmark
1989 - 1997
Singleton pregnancies in Danish-speaking women who attended for antenatal care and delivered at Aarhus University Hospital during the study period. All women who reported chronic disease other than epilepsy were excluded. Children of women with epilepsy exposed to carbamazepine monotherapy during the first trimester of pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Children of women with epilepsy without treatment.
37 / 106
Kaaja (Carbamazepine), 2003 Finland
1980 - 1998
All women with epilepsy regardless of whether they used antiepileptic drugs during the index pregnancy. Infants whose epileptic mothers took carbamazepine monotherapy during the first trimester. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Infants whose epileptic mothers didn't take any antiepileptic drugs during the first trimester.
363 / 239
Källén (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Indications NOS), 2013 Swedish
1996 - 2011
Nearly all births in Sweden during the study period (1,575,847) are registered in The Swedish Medical Birth Register. Infants whose mothers used carbamazepine in monotherapy in early pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Infants whose mothers used lamotrigine in monotherapy in early pregnancy.
1511 / 1084 Overlapping: Cohen 2023 and Kallen 2013: less of 50% of overlapping => the 2 studies were kept. Razaz 2017; Wide 2004; Bodén 2012 outcomes' already included in Källèn 2013 or without adequate control group. Follow-up period: author's email reply.
Källén (Carbamazepine) (Controls unexposed, NOS) (Indications NOS), 2013 Sweden
1996 - 2011
Nearly all births in Sweden during the study period (1,575,847) are registered in The Swedish Medical Birth Register. Infants whose mothers used carbamazepine in monotherapy in early pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed (general population or NOS)
Infants in population whose mothers used at least one of a central nervous system active drugs (less than 3%) or weren't exposed in early pregnancy.
1511 / 1575847 Overlapping: Cohen 2023 and Kallen 2013: less of 50% of overlapping => the 2 studies were kept. Razaz 2017; Wide 2004; Bodén 2012 outcomes' already included in Källèn 2013 or without adequate control group. Follow-up period: author's email reply.
Kaneko (Carbamazepine), 1999 Japan, Italy and Canada.
1978 - 1991
Female patient of childbearing age with epilepsy who visited clinics and who consented to be followed throughout their pregnancy. The data from three studies carried out in Canada, Japan and Italy were pooled. Offspring whose epileptic mothers were under carbamazepine monotherapy until term. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Offspring from epileptic mothers without antiepileptic drug exposure until term.
158 / 98 Details about the design were completed thanks to Battino et al., 1999 publication. Kaneko 1999 overlapped with Kaneko 1986, 1988, 1992, Oguni 1992, Dansky 1982, Canger 1999 and Battino 1992.
Kasradze (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2017 Georgia
2001
Women with epilepsy whose children had reached ages from 36 to 72 months at the time of the study and registered in the registry. Children born to epileptic mothers exposed to carbamazepine monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Children born to epileptic mothers exposed to lamotrigine monotherapy during pregnancy.
16 / 3 Children with major congenital malformations were excluded from the study.
Kasradze (Carbamazepine) (Controls unexposed, disease free), 2017 Georgia
2001
Women with epilepsy whose children had reached ages from 36 to 72 months at the time of the study and registered in the registry. Children born to epileptic mothers exposed to carbamazepine monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Children born to mothers without epilepsy, with no antiepileptic drug or other drug treatment during pregnancy
16 / 50 Children with major congenital malformations were excluded from the study.
Katz (Carbamazepine), 2001 USA
1990 - 2000
The clinical histories of women with epilepsy cared for at the center, contributing 103 newborns during the study period. Newborn of women with epilepsy exposed to carbamazepine monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Newborn of women with epilepsy exposed to lamotrigine monotherapy during pregnancy.
21 / 3 The analysis of developmental delay excluded the 20 pregnancies occurring within 1 year of chart review because of insufficient time to evaluate developmental milestones.
Kilic (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2014 Denmark
1997 - 2008
All singleton live-born children in Denmark during the study period. Children whose mothers have been exposed to carbamazepine in monotherapy during the exposure window defined from 30 days before the estimated day of conception to the day prior to birth. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Children whose mothers have been exposed to lamotrigine in monotherapy during the exposure window defined from 30 days before the estimated day of conception to the day prior to birth.
347 / 880 Less than 90% of women are epileptic.
Kilic (Carbamazepine) (Controls unexposed NOS) (Mixed indications), 2014 Denmark
1997 - 2008
All singleton live-born children in Denmark during the study period. Children whose mothers have been exposed to carbamazepine in monotherapy during the exposure window defined from 30 days before the estimated day of conception to the day prior to birth. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed (general population or NOS)
Children whose mothers haven't been exposed to antiepileptic drugs 30 days before the estimated day of conception to the day of birth.
347 / 676834 Less than 90% of women are epileptic.
Kilic (Carbamazepine) (Controls unexposed, sick) (Mixed indications), 2014 Denmark
1997 - 2008
All singleton live-born children in Denmark during the study period. Children whose mothers have been exposed to carbamazepine in monotherapy during the exposure window defined from 30 days before the estimated day of conception to the day prior to birth. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Children whose mothers have an epilepsy diagnosis and haven't been exposed to antiepileptic drugs 30 days before the estimated day of conception to the day of birth.
347 / 5296 Less than 90% of women are epileptic.
Kini (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2006 UK
1989 - 1999
375 children aged between 6 months and 16 years from 219 mothers with epilepsy exposed and not exposed to antiepileptic drugs during pregnancy attending epilepsy clinics or antenatal care between the study period. Children exposed to carbamazepine monotherapy during pregnancy and with epileptic mothers. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Children exposed to lamotrigine monotherapy during pregnancy and with epileptic mothers.
94 / 9 Because we don't know the exact number of children exposed to lamotrigine and analyzed for malformations, this outcome cannot be reported here.
Kini (Carbamazepine) (Controls unexposed, sick), 2006 UK
1989 - 1999
375 children aged between 6 months and 16 years from 219 mothers with epilepsy exposed and not exposed to antiepileptic drugs during pregnancy attending epilepsy clinics or antenatal care between the study period. Children exposed to carbamazepine monotherapy during pregnancy and with epileptic mothers. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Children not exposed to antiepileptic drugs during pregnancy and with epileptic mothers.
94 / 101 A better review of the WISC score for children aged 6 and above are provided by Adab 2004 publication.
Li (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2023 China
2009 - 2022
All pregnant participants occurring between 2009 and 2022 in the cohort of women with epilepsy (WWE) of childbearing age (20–45 years old) enrolled from 31 medical institutions. Women with epilepsy (WWE) using Carbamazepine monotherapy during pregnancy. exposed to other treatment, sick
Women with epilepsy (WWE) using Lamotrigine monotherapy during pregnancy.
31 / 38 Authors did not provide analysis after monotherapy exposure but raw data of major congenital malformation provided in the e-Supp allowed to extract data for monotherapy => only this outcome reported here. Overlapping: He 2017 totally included in Li 2023.
Li (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 China
2009 - 2022
All pregnant participants occurring between 2009 and 2022 in the cohort of women with epilepsy (WWE) of childbearing age (20–45 years old) enrolled from 31 medical institutions. Women with epilepsy (WWE) using Carbamazepine monotherapy during pregnancy. unexposed, sick
Women with epilepsy (WWE) not using antiseizure medications during pregnancy.
31 / 253 Authors did not provide analysis after monotherapy exposure but raw data of major congenital malformation provided in the e-Supp allowed to extract data for monotherapy => only this outcome reported here. Overlapping: He 2017 totally included in Li 2023.
Mari (Carbamazepine), 2022 Rome, Italy
2009 - 2019
Pregnant women with focal epilepsy (FE) or generalized epilepsy (GE) followed at epilepsy centers during the study period including women on Anti-seizure medications with carbamazepine, lamotrigine or levetiracetam. Women with focal epilepsy (FE) or generalized epilepsy (GE) undergoing Anti-seizure medications monotherapy with carbamazepine. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Women with focal epilepsy (FE) or generalized epilepsy (GE) undergoing Anti-seizure medications monotherapy with lamotrigine.
29 / 11 In 46 out of 57 pregnancies, ASMs therapy remained unchanged during gestation (only one switch from CBZ to LEV, others are dosage-related).
Mawer (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2010 UK
2000 - 2006
Midwives in the antenatal clinics approached each woman, who gave a history of epilepsy (n=231), whatever her stage of gestation. Children born to mothers with epilepsy exposed to carbamazepine monotherapy in utero. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Children born to mothers with epilepsy exposed to lamotrigine monotherapy in utero.
74 / 40 Kini's 2007 malformation results are overlapped. 39% WWE also actively participated in a NEAD study in Meador 2006. Specific major malformations' numerators are extracted from the review by Weston et al. 2016. Period of exposure confirm by author's email.
Mawer (Carbamazepine) (Controls unexposed, disease free), 2010 UK
2000 - 2006
Women with epilepsy (WWE) and the healthy woman controls attending the same clinic. Children born to mothers with epilepsy exposed to carbamazepine monotherapy in utero. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Children born to mothers without epilepsy who attended the same clinic on the same day or a few days later.
74 / 315 Kini's 2007 malformation results are overlapped. Specific major malformations' numerators are extracted from the review by Weston et al. 2016 because not classified per types in the original publication. Period of exposure confirm by author's email.
Mawer (Carbamazepine) (Controls unexposed, sick), 2010 UK
2000 - 2006
Midwives in the antenatal clinics approached each woman, who gave a history of epilepsy (n=231), whatever her stage of gestation. Children born to mothers with epilepsy exposed to carbamazepine monotherapy in utero. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Children born to women with untreated epilepsy, who took no antiepileptic drugs before or during pregnancy.
74 / 46 Kini's 2007 malformation results are overlapped. Specific major malformations' numerators are extracted from the review by Weston et al. 2016 because not classified per types in the original publication. Period of exposure confirm by author's email.
McVearry (Carbamazepine), 2009 UK and USA
1999 - 2004
Pregnant women age 18–35 at time of pregnancy with epilepsy who were taking a single antiepileptic drug for a minimum period of 6 months and enrolled during the first trimester. Preschool children whose mothers were exposed to carbamazepine in monotherapy during pregnancy for a minimum period of 6 months. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Preschool children whose mothers were exposed to lamotrigine in monotherapy during pregnancy.
16 / 17 In utero AED monotherapy exposure for a minimum period of six months.
Meador (Carbamazepine), 2006 USA and UK
1999 - 2004
Pregnant women with epilepsy treated with antiepileptic drugs in monotherapy. Infants of women exposed to carbamazepine in monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Infants of women exposed to lamotrigine in monotherapy during pregnancy.
110 / 98 Malformations secondary to known genetic disorders and chromosomal abnormalities are not considered within the major malformation group. 108 women with epilepsy are also used in Mawer 2010 so there is a 33% overlap for malformations.
Meador (Carbamazepine), 2009 UK and USA
1999 - 2004
Livebirths (n=309) of pregnant women with epilepsy who were receiving antiepileptic drugs in monotherapy. Infants of women exposed to carbamazepine in monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Infants of women exposed to lamotrigine in monotherapy during pregnancy.
92 / 99 Meador 2011 is completely overlapped with this study which gives a better review of the IQ at age 3 years old (more exposed pregnancies). The cognitive delay at 3 years old is already evaluated in Meador et al., 2013.
Meador (Carbamazepine), 2011 UK and USA
1999 - 2004
Pregnant women (n=211) with epilepsy who were taking a single antiepileptic drug in one of the 25 centers across UK and USA. Infants of women exposed to carbamazepine in monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Infants of women exposed to lamotrigine in monotherapy during pregnancy.
59 / 70 A non-exposed control group was not included.
Meador (Carbamazepine), 2013 UK and USA.
1999 - 2004
Livebirths (n=311) of pregnant women with epilepsy who were receiving a single antiepileptic drug in one of the 25 centers across UK and USA between the study period. Infants of epileptic mothers exposed to carbamazepine in monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Infants of epileptic mothers exposed to lamotrigine in monotherapy during pregnancy.
94 / 100 A nonexposed control group was not included. Meador 2020 and Cohen 2019 are re-examination or an assessment of subscales of data already assessed in this publication. Cognitif assessment in Meador 2009 and 2011 (x2) is better assessed in this publication.
Meador (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2020 US
2012 - 2016
Pregenant women with epilepsy were recruited primarily from the clinical populations at the 20 MONEAD sites, but also via referral from physicians, as well as self-referral. They were ages 14–45 years and ≤20 weeks gestational age. Children born to pregnant women with epilepsy exposed to carbamazepine monotherapy during the first trimester. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Children born to pregnant women with epilepsy exposed to lamotrigine monotherapy during the first trimester.
14 / 113
Meador (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2021 US
2012 - 2016
Pregnant (gestational age of 20 weeks or less) women with epilepsy and healthy women were recruited from the 20 epilepsy practices and through referral from obstetricians and other physicians as well as self-referral. Children with epileptic mothers using carbamazepine monotherapy in the third trimester. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Children with epileptic mothers using lamotrigine monotherapy in the third trimester.
12 / 93 Exclusion criteria included history of psychogenic nonepileptic spells, expected IQ of less than 70, other major medical illness, and switching of ASMs in pregnancy before enrollment.
Meador (Carbamazepine) (Controls unexposed, disease free), 2020 US
2012 - 2016
Pregenant women with epilepsy were recruited primarily from the clinical populations at the 20 MONEAD sites, but also via referral from physicians, as well as self-referral. They were ages 14–45 years and ≤20 weeks gestational age. Children born to pregnant women with epilepsy exposed to carbamazepine monotherapy during the first trimester. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Children born to healthy pregnant women.
14 / 106
Meador (Carbamazepine) (Controls unexposed, disease free), 2021 US
2012 - 2016
Pregnant (gestational age of 20 weeks or less) women with epilepsy and healthy women were recruited from the 20 epilepsy practices and through referral from obstetricians and other physicians as well as self-referral. Children with epileptic mothers using carbamazepine monotherapy in the third trimester. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Children of healthy women.
12 / 106 Exclusion criteria included history of psychogenic nonepileptic spells, expected IQ of less than 70, other major medical illness, and switching of ASMs in pregnancy before enrollment.
Meador (Carbamazepine) (Controls unexposed, sick), 2020 US
2012 - 2016
Pregenant women with epilepsy were recruited primarily from the clinical populations at the 20 MONEAD sites, but also via referral from physicians, as well as self-referral. They were ages 14–45 years and ≤20 weeks gestational age. Children born to pregnant women with epilepsy exposed to carbamazepine monotherapy during the first trimester. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Children born to pregnant women with epilepsy with no antiepileptic drug use.
14 / 15
Miškov (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2016 Croatia
2003 - 2013
Pregnant women with epilepsy during the study period at the the Sestre milosrdnice University Hospital Center. Pregnancies in women with epilepsy on carbamazepine monotherapy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Pregnancies in women with epilepsy on lamotrigine monotherapy.
13 / 37 Includes all Miskov's 2010 outcomes.
Miškov (Carbamazepine) (Controls unexposed, disease free), 2016 Croatia
2003 - 2013
Pregnant women with epilepsy during the study period at the the Sestre milosrdnice University Hospital Center. Pregnancies in women with epilepsy on carbamazepine monotherapy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Pregnancies in healthy controls.
13 / 147 Includes all Miskov's 2010 outcomes.
Miškov (Carbamazepine) (Controls unexposed, sick), 2016 Croatia
2003 - 2013
Pregnant women with epilepsy during the study period at the the Sestre milosrdnice University Hospital Center. Pregnancies in women with epilepsy on carbamazepine monotherapy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Pregnancies in women with epilepsy without antiepileptic drugs.
13 / 4 Includes all Miskov's 2010 outcomes.
Nadebaum (Carbamazepine), 2011 Australia
2007 - 2009
160 women with epilepsy and their 173 children aged 6 to 8 years recruited through the register. Children exposed to carbamazepine monotherapy in utero from epileptic mother. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Children exposed to lamotrigine monotherapy in utero from epileptic mother.
34 / 9 Children with major birth defects or a diagnosis of epilepsy were ineligible for the study to avoid possible confounding effects of these known risk factors for intellectual impairment.
Nulman (Carbamazepine) (Controls unexposed, NOS) (Mixed indications), 1997 Canada
1987 - 1992
Pregnant women treated with either phenytoin or carbamazepine in monotherapy and an additional group of women with epilepsy who did not take medications during the index pregnancy and seen between the study period. Mother-child pairs exposed to carbamazepine in monotherapy at least during the first trimester. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed (general population or NOS)
Child from the next woman attending the Motherisk Clinic whose reason for attendance was counseling after gestational exposure to nonteratogens.
36 / 36 Less than 90% of women are taking Carbamazepine for epilepsy. Gladstone 1992 malformations result's are partly included in this study due to overlapping of the study period with the same register.
Nulman (Carbamazepine) (Controls unexposed, sick) (Mixed indications), 1997 Canada
1987 - 1992
Pregnant women treated with either phenytoin or carbamazepine in monotherapy and an additional group of women with epilepsy who did not take medications during the index pregnancy and seen between the study period. Mother-child pairs exposed to carbamazepine in monotherapy at least during the first trimester. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Child from epileptic women who did not receive drug therapy during the index pregnancy.
36 / 9 Less than 90% of women are taking Carbamazepine for epilepsy. Gladstone 1992 malformations result's are partly included in this study due to overlapping of the study period with the same register.
Ornoy (Carbamazepine), 1996 Israel
1988 - 1994
119 calls about epileptic women who were treated with carbamazepine alone, or in combination with other anticonvulsants. Children whose epileptic mothers used carbamazepine as their sole anticonvulsant throughout pregnancy. unexposed (general population or NOS)
Children whose mothers were unexposed to carbamazepine.
47 / 47 Ornoy 1996 major malformations results are already included in Diav-Citrin 2001 with more exposed pregnancies. Children were excluded from analysis because of prematurity (born before 32 weeks of gestation).
Pekoz (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2023 Turkey
2014 - 2019
Pregnant women with epilepsy (PWWE) followed up at the participating centers during the study period, with a live birth. Pregnant women with epilepsy (PWWE) receiving Carbamazepine as monotherapy. exposed to other treatment, sick
Pregnant women with epilepsy (PWWE) receiving Lamotrigine as monotherapy.
141 / 141
Pekoz (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Turkey
2014 - 2019
Pregnant women with epilepsy (PWWE) followed up at the participating centers during the study period, with a live birth. Pregnant women with epilepsy (PWWE) receiving Carbamazepine as monotherapy. unexposed, sick
Pregnant women with epilepsy (PWWE), antiseizure medication free.
141 / 43
Pennell (Carbamazepine), 2012 USA and UK
1999 - 2004
Pregnant women with epilepsy (n=329) producing 311 live births, who were taking a single antiepileptic drug at time of conception to enrollment in one of the 25 centers across UK and USA. Infants of women exposed to carbamazepine in monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Infants of women exposed to lamotrigine in monotherapy during pregnancy.
93 / 98
Ren (Carbamazepine) (Mixed indications), 2023 Denmark
1997 - 2002
All live-born singletons in Denmark between the study period. Children exposed in utero to carbamazepine monotherapy, prescribed and redeemed within the exposure window defined from 30 days before the first day of the last menstrual period to 1 day before birth. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed (general population or NOS)
Children unexposed in utero to any antiepileptic drugs within the exposure time window during pregnancy.
290 / 370569 Overlapping: this publication totally included the data of Elkjaer, 2018, for an higher academic grade => use of Ren 2023. Mixed indication (226/290 epilepsy (78%)).
Richards (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Indications NOS), 2019 New Zealand
2008 - 2012
Between 2012 and 2016, 89% of all eligible four-year-olds participated in the program. Children exposed to carbamazepine monotherapy during pregnancy (the exposure window was defined as nine months before the day of birth). (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Children exposed to lamotrigine monotherapy during pregnancy (the exposure window was defined as nine months before the day of birth).
201 / 149 The National Minimum Dataset does not provide reliable diagnosis information. Indications not specified.
Richards (Carbamazepine) (Controls unexposed, NOS) (Indications NOS), 2019 New Zealand
2008 - 2012
Between 2012 and 2016, 89% of all eligible four-year-olds participated in the program. Children exposed to carbamazepine monotherapy during pregnancy (the exposure window was defined as nine months before the day of birth). (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed (general population or NOS)
All other children unexposed to antiepileptic drug in utero who had a Before School Check (B4SC) in the study period.
201 / 286966 The National Minimum Dataset does not provide reliable diagnosis information. Indications not specified.
Robert (Carbamazepine), 1986 France
1976 - 1983
148 infants born of epileptic women were identified from two sources: hospital records of women having had an EEG between 1976 and 1983 and 3 maternity with computerized records from 1979 - 1983. Infants born from epileptic mothers exposed during the first trimester to carbamazepine in monotherapy. unexposed, sick
Infants born from epileptic mothers unexposed during the first trimester to any antiepileptic drugs.
3 / 35
Samrén (Carbamazepine), 1999 Netherlands
1972 - 1994
Offspring of women with epilepsy, with or without antiepileptic drug use during pregnancy, born during the study period. Children born to mothers with epilepsy and using carbamazepine monotherapy at least during the first trimester of pregnancy unexposed, disease free
Children born to nonepileptic nonexposed women.
376 / 2000
Sonneveld (Carbamazepine) (Controls unexposed NOS), 1990 Tasmania
1981- 1988
Pregnancies of all private and public patients in Tasmania during the study period. 56,557 deliveries during the study period of which 347 were in patients with epilepsy. Epileptic pregnancies exposed to carbamazepine monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed (general population or NOS)
Total number of deliveries during the study period.
74 / 56557 The total population of this study serves as a control group, thus it includes the exposed group but accounting only for 0.6% of the sample. In the result authors used 55953 for the total number of deliveries when all perinatal deaths are excluded.
Sonneveld (Carbamazepine) (Controls unexposed, sick), 1990 Tasmania
1981- 1988
Pregnancies of all private and public patients in Tasmania during the study period. 56,557 deliveries during the study period of which 347 were in patients with epilepsy. Epileptic pregnancies exposed to carbamazepine monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Epileptic pregnancies who used no anticonvulsant drug therapy.
74 / 87
Steegers-Theunissen (Carbamazepine), 1994 Netherlands
Not specified
Epileptic and healthy control women visiting the outpatient departments were recruited before conception and just one singleton pregnancy per woman is studied. Singleton of epileptic women exposed to carbamazepine monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Singleton of healthy women unexposed during pregnancy.
39 / 106 Women could only participate if they or any first-degree relative had no genetic disorder known to cause major congenital malformations, and if they were not under treatment for infectious, metabolic, endocrine or malignant diseases.
The NAAED (Controls exposed to Lamotrigine, sick) (Indications NOS), 2022 North America and Canada
1997 - 2020
Pregnant women who are taking an antiepileptic drug for any reason and had a liveborn infant, a stillborn infant, or a pregnancy terminated because of a fetal abnormality and enrolled as 'pure' or 'traditional' enrollees. Infants of pregnant women who used carbamazepine as monotherapy, during the first trimester. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Infants of pregnant women who used lamotrigine as monotherapy, during the first trimester.
1122 / 2333 Study design completed with the publication of Hernández-Díaz et al. 2012. Data extracted from the North American AED pregnancy registry website. Indications not specified.
The NAAED (Controls unexposed, disease free) (Indications NOS), 2022 North America and Canada
1997 - 2020
Pregnant women who are taking an antiepileptic drug for any reason and had a liveborn infant, a stillborn infant, or a pregnancy terminated because of a fetal abnormality and enrolled as 'pure' or 'traditional' enrollees. Infants of pregnant women who used carbamazepine as monotherapy, during the first trimester. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Infants of pregnant women, not taking an antiepileptic drug and without epilepsy, who were recruited from among the friends and family members of the enrolled women taking an antiepileptic drug.
1122 / 1201 Study design completed with the publication of Hernández-Díaz et al. 2012. Data extracted from the North American AED pregnancy registry website. Internal control group reported rather than the external (for relevance purpose). Indications not specified.
Thomas (Carbamazepine), 2022 India
1998 - 2006
Children (13–21 years) of women with epilepsy (CWWE) who were 13 years old or older on 31 December 2019 and had undergone developmental assessment at one year. Children of women with epilepsy (CWWE) exposed to Carbamazepine monotherapy during pregnancy. unexposed, sick
Children of women with epilepsy (CWWE) not exposed to antiseizure medications during pregnancy.
38 / 11 Overlapping: Thomas 2022 included data on language and cognitive delay, also evaluated in Sreedharan et al., 2018; Thomas 2007 and Gopinath 2015, but with more exposed pregnancies, more relevant control group and older children => Use of Thomas 2022.
Thomas (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2021 India
1998 - 2019
All pregnancies with known outcomes in women with epilepsy enrolled in the registry during 1998 - 2013 and the diagnosis of epilepsy was confirmed before registration. Children of women with epilepsy using carbamazepine monotherapy any time during the first trimester of pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Children of women with epilepsy using lamotrigine monotherapy any time during the first trimester of pregnancy.
490 / 50 Study design completed with Thomas et al., 2017. Keni's 2018 malformations results are already reported in this publication.
Thomas (Carbamazepine) (Controls unexposed, disease free), 2021 India
1998 - 2015
All pregnancies with known outcomes in women with epilepsy enrolled in the registry during 1998 - 2013 and the diagnosis of epilepsy was confirmed before registration. Children of women with epilepsy using carbamazepine monotherapy any time during the first trimester of pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Children of women without epilepsy in the first trimester of pregnancy and not using antiepileptic drugs from the antenatal clinic of government hospital.
389 / 319 This external control group is only available in the 2017 publication.
Thomas (Carbamazepine) (Controls unexposed, sick), 2021 India
1998 - 2019
All pregnancies with known outcomes in women with epilepsy enrolled in the registry during 1998 - 2013 and the diagnosis of epilepsy was confirmed before registration. Children of women with epilepsy using carbamazepine monotherapy any time during the first trimester of pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Children of women with epilepsy not using any antiepileptic drugs during the first trimester.
490 / 340 Study design completed with Thomas et al., 2017. Thomas et al., 2008 completely overlapped with this publication.
Thomas b (Carbamazepine), 2008 India
1998 - 2004
395 infants born to mothers with epilepsy enrolled in the preconception period or during early pregnancy before the fetal outcome is known. Infants whose epileptic mothers were on carbamazepine monotherapy anytime during the pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Infants not prenatally exposed to antiepileptic drugs anytime during the pregnancy.
101 / 32 The Developmental Assessment Scale for Indian Infants (DASII) is an adaptation of the Bayley Scale of Infant Development standardized for Indian infants.
Titze (Carbamazepine) (Controls unexposed, disease free), 2008 Germany
1976 - 1984
Adolescents born during the study period from mothers randomly recruited during their pregnancy, were asked to participate if they had been followed up to 6 years of age. Adolescents whose epileptic mothers were exposed to carbamazepine monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Adolescents from non-affected mothers.
4 / 49
Titze (Carbamazepine) (Controls unexposed, sick), 2008 Germany
1976 - 1984
Adolescents born during the study period from mothers randomly recruited during their pregnancy, were asked to participate if they had been followed up to 6 years of age. Adolescents whose epileptic mothers were exposed to carbamazepine monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Adolescents whose epileptic mothers weren't exposed to any antiepileptic drugs during pregnancy.
4 / 13
Tomson (Carbamazepine), 2018 42 countries
1999 - 2016
Pregnancies registered in the database during the study period who had been exposed to antiepileptic drug monotherapy and had complete follow-up data up to 1 year. They were enrolled within gestation week 16 and before fetal outcome is known. Offspring exposed in utero to carbamazepine monotherapy during the first trimester and born from epileptic mothers. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Offspring exposed in utero to lamotrigine monotherapy during the first trimester and born from epileptic mothers.
1957 / 2514 Martinez4 2009 and 2018 malformations results already included in this study. This study is an update of Tomson's 2011 publication. They excluded from the current analysis pregnancies occurring in women without epilepsy. EURAP registry: potential overlap.
Tomson (Carbamazepine), 2015 42 countries
1999 - 2013
Pregnant women (n=6,146) treated with antiepileptic drugs for any indication at the time of conception, enrolment within gestation week 16 and before fetal outcome is known. Pregnancies in women with epilepsy treated with carbamazepine monotherapy at least during the first trimester. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Pregnancies in women with epilepsy treated with lamotrigine monotherapy at least during the first trimester.
1713 / 1910 Pregnancies that occurred in women without epilepsy were excluded. EURAP registry: potential overlap.
Trivedi (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2018 India
1998 - 2015
All women with epilepsy who had completed their pregnancies and enrolled in the registry between the study period. The diagnosis of epilepsy was confirmed before registration. Pregnant women with epilepsy who used carbamazepine monotherapy any time during the first trimester of pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Pregnant women with epilepsy who used lamotrigine monotherapy any time during the first trimester of pregnancy.
465 / 48 Study design partly completed with cites source Thomas et al., 2017.
Trivedi (Carbamazepine) (Controls unexposed, sick), 2018 India
1998 - 2015
All women with epilepsy who had completed their pregnancies and enrolled in the registry between the study period. The diagnosis of epilepsy was confirmed before registration. Pregnant women with epilepsy who used carbamazepine monotherapy any time during the first trimester of pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Pregnant women with epilepsy who were not on antiepileptic drug during their first trimester.
465 / 178 Study design partly completed with cites source Thomas et al., 2017.
Vajda (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2019 Australia
1999 - 2018
Pregnant women taking antiepileptic drugs for any indications or not treated with antiepileptic drugs in at least the first half of pregnancy. Offsprings born from women nearly always with epilepsy exposed to carbamazepine in monotherapy in at least the first trimester of pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Offsprings born from women nearly always with epilepsy exposed to lamotrigine in monotherapy in at least the first trimester of pregnancy.
409 / 406 Women with epilepsy accounted for 98.3%. Completely overlap Vajda 2007 (x2); 2010 (x2); 2012 (x2); 2013; 2014. Study design partly completed with Vajda 2013.
Vajda (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2018 Australia
1999 - 2016
Pregnant women whether treated with antiepileptic drugs or left untreated in at least the first half of pregnancy. Offsprings of pregnant women with epilepsy exposed to carbamazepine in monotherapy throughout. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Offsprings of pregnant women with epilepsy exposed to lamotrigine in monotherapy throughout.
404 / 382
Vajda (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013 Australia
1999 - 2013
Pregnant women with epilepsy whether treated with antiepileptic drugs or left untreated or pregnant women taking antiepileptic drugs for other purposes. Offsprings from women with epilepsy exposed to carbamazepine in monotherapy in at least the first trimester of pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Offsprings from women with epilepsy exposed to lamotrigine in monotherapy in at least the first trimester of pregnancy.
361 / 315 Women taking AED for epilepsy are in majority (more than 90%). Vajda 2019 provides the most recent update for major malformations results for this register. Specific malformations' results are extracted from the review by Weston et al. 2016.
Vajda (Carbamazepine) (Controls unexposed, sick), 2019 Australia
1999 - 2018
Pregnant women taking antiepileptic drugs for any indications or not treated with antiepileptic drugs in at least the first half of pregnancy. Offsprings born from women nearly always with epilepsy exposed to carbamazepine in monotherapy in at least the first trimester of pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Offsprings born from women nearly always with epilepsy not treated with antiepileptic drugs in at least the first half of pregnancy.
409 / 176 Women with epilepsy accounted for 98.3%. Completely overlap Vajda 2007 (x2); 2010 (x2); 2012 (x2); 2013; 2014. Study design partly completed with Vajda 2013.
Vajda (Carbamazepine) (Controls unexposed, sick), 2018 Australia
1999 - 2016
Pregnant women whether treated with antiepileptic drugs or left untreated in at least the first half of pregnancy. Offsprings of pregnant women with epilepsy exposed to carbamazepine in monotherapy throughout. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Offsprings of pregnant women with epilepsy that have been untreated in at least the first half of pregnancy.
404 / 170
Vajda (Carbamazepine) (Controls unexposed, sick), 2013 Australia
1999 - 2013
Pregnant women with epilepsy whether treated with antiepileptic drugs or left untreated or pregnant women taking antiepileptic drugs for other purposes. Offsprings from women with epilepsy exposed to carbamazepine in monotherapy in at least the first trimester of pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Offsprings from women with epilepsy not exposed to antiepileptic drugs in at least the first trimester of pregnancy.
361 / 147 Women taking AED for epilepsy are in majority (more than 90%). Vajda 2019 provides the most recent update for major malformations results for this register. Specific malformations results are extracted from the review by Weston et al. 2016.
Van der Pol (Carbamazepine) (Controls unexposed, disease free), 1991 The Netherlands
1973 - 1981
During the study period, epileptic mothers were delivered of a live-born infant at the hospital. Infants were selected with the following criteria: antiepileptic medication phenobarbital and/or carbamazepine or none; no evidence of intrauterine infection or chromosomal abnormalities and absence of additional drug exposure. Children born to epileptic mothers exposed to carbamazepine only throughout pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Children of nonepileptic mothers selected from singletons born in the same period.
12 / 61
Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 The Netherlands
1973 - 1981
During the study period, epileptic mothers were delivered of a live-born infant at the hospital. Infants were selected with the following criteria: antiepileptic medication phenobarbital and/or carbamazepine or none; no evidence of intrauterine infection or chromosomal abnormalities and absence of additional drug exposure. Children born to epileptic mothers exposed to carbamazepine only throughout pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Children born to epileptic mothers not exposed to antiepileptic medication.
12 / 24
Vanya (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2015 Hungary
2000 - 2014
All pregnant women with epilepsy who contacted the department between the study period. Neonates of epileptic women treated with carbamazepine monotherapy throughout the nine months of pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Neonates of epileptic women treated with lamotrigine monotherapy throughout the nine months of pregnancy.
10 / 6 Chromosomal anomalies and genetic syndromes were excluded from the study. The only exploitable outcome with a control group concern major congenital malformation.
Vanya (Carbamazepine) (Controls unexposed, sick), 2015 Hungary
2000 - 2014
All pregnant women with epilepsy who contacted the department between the study period. Neonates of epileptic women treated with carbamazepine monotherapy throughout the nine months of pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Neonates of epileptic women treatment-naive for antiepileptic drugs during pregnancy (not exposed to antiepileptic drugs).
10 / 20 Chromosomal anomalies and genetic syndromes were excluded from the study. The only exploitable outcome with a control group concern major congenital malformation.
Veiby (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2014 Norway
1999 - 2011
777,785 deliveries recorded in the database during the study period. Children exposed prenatally to carbamazepine as monotherapy indicated for their mothers' epilepsy or other indications. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Children exposed prenatally to lamotrigine as monotherapy indicated for their mothers' epilepsy or other indications.
685 / 833 Overlapping: Cohen 2023 and Veiby 2014 => less of 50% of overlapping => the 2 studies were kept. Less than 90% of women are treated with Carbamazepine and Lamotrigine for epilepsy (Mixed indications).
Veiby (Carbamazepine) (Controls exposed to Lamotrigine, sick) a, 2013 Norway
1999 - 2008
108,976 children were registered in the Norwegian Mother and Child Cohort Study cohort from pregnant women attending routine ultrasonographic scanning recruited from hospitals and maternity units. Children exposed to carbamazepine monotherapy during pregnancy born from epileptic mothers. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Children exposed to lamotrigine monotherapy during pregnancy born from epileptic mothers.
48 / 71 Overlap for the neuro-developmental outcomes at 18 and 36 months old and the 'weight less than 10th percentile' outcomes with Bjørk 2018.
Veiby (Carbamazepine) (Controls exposed to Lamotrigine, sick) b, 2013 Western Norway, Hordaland County.
1999 - 2008
107,072 pregnancies were registered in the MoBa cohort with a total of 108,976 children, constituting approximately 18 % of all births in Norway during this period. Children exposed to carbamazepine monotherapy during pregnancy born from epileptic mothers. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Children exposed to lamotrigine monotherapy during pregnancy born from epileptic mothers.
69 / 104 Veiby 2013 major malformations results are already included in Veiby 2014 and risk of ASD better studied in Bjørk 2018 (with more exposed pregnancies). Small for gestationnal age results of Farmen 2015 are completely overlapped by this study.
Veiby (Carbamazepine) (Controls unexposed, disease free) (Mixed indications), 2014 Norway
1999 - 2011
777,785 deliveries recorded in the database during the study period. Children exposed prenatally to carbamazepine as monotherapy indicated for their mothers' epilepsy or other indications. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
All unexposed children born to women without epilepsy.
685 / 771412 Overlapping: Cohen 2023 and Veiby 2014 => less of 50% of overlapping => the 2 studies were kept. Less than 90% of women are treated with Carbamazepine for epilepsy (Mixed indications).
Veiby (Carbamazepine) (Controls unexposed, disease free) a, 2013 Norway
1999 - 2008
108,976 children were registered in the Norwegian Mother and Child Cohort Study cohort from pregnant women attending routine ultrasonographic scanning recruited from hospitals and maternity units. Children exposed to carbamazepine monotherapy during pregnancy born from epileptic mothers. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Children of parents without epilepsy unexposed to antiepileptic drugs during pregnancy.
48 / 77770 Overlap for the neuro-developmental outcomes at 18 and 36 months old and the 'weight less than 10th percentile' outcome with Bjørk 2018.
Veiby (Carbamazepine) (Controls unexposed, disease free) b, 2013 Western Norway, Hordaland County.
1999 - 2008
107,072 pregnancies were registered in the MoBa cohort with a total of 108,976 children, constituting approximately 18 % of all births in Norway during this period. Children exposed to carbamazepine monotherapy during pregnancy born from epileptic mothers. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Children of parents without epilepsy unexposed to antiepileptic drugs during pregnancy.
69 / 107597 Veiby 2013 major malformations results are already included in Veiby 2014 and risk of ASD better studied in Bjørk 2018 (with more exposed pregnancies). Small for gestationnal age results of Farmen 2015 are completely overlapped by this study.
Veiby (Carbamazepine) (Controls unexposed, sick) (Mixed indications), 2014 Norway
1999 - 2011
777,785 deliveries recorded in the database during the study period. Children exposed prenatally to carbamazepine as monotherapy indicated for their mothers' epilepsy or other indications. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Children born to women with a history of epilepsy but no antiepileptic drug treatment during pregnancy.
685 / 3773 Overlapping: Cohen 2023 and Veiby 2014 => less of 50% of overlapping => the 2 studies were kept. Less than 90% of women are treated with Carbamazepine for epilepsy (Mixed indications).
Veiby (Carbamazepine) (Controls unexposed, sick) a, 2013 Norway
1999 - 2008
108,976 children were registered in the Norwegian Mother and Child Cohort Study cohort from pregnant women attending routine ultrasonographic scanning recruited from hospitals and maternity units. Children exposed to carbamazepine monotherapy during pregnancy born from epileptic mothers. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Children of mothers with epilepsy unexposed to antiepileptic drugs during pregnancy.
48 / 276 Overlap for the neuro-developmental outcomes at 18 and 36 months old and the 'weight less than 10th percentile' outcomes with Bjørk 2018.
Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013 Western Norway, Hordaland County.
1999 - 2008
107,072 pregnancies were registered in the MoBa cohort with a total of 108,976 children, constituting approximately 18 % of all births in Norway during this period. Children exposed to carbamazepine monotherapy during pregnancy born from epileptic mothers. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Children of mothers with epilepsy not treated with antiepileptic drugs during pregnancy.
69 / 393 Veiby 2013 major malformations results are already included in Veiby 2014 and risk of ASD better studied in Bjørk 2018 (with more exposed pregnancies). Small for gestationnal age results of Farmen 2015 are completely overlapped by this study.
Videman (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2016 Finland
2009 - 2013
All pregnant women with epilepsy (PWE) treated with antiepileptic drugs living in Helsinki between the study period. Pregnant women with no antiepileptic drug or other brain-acting medication was recruited by a nurse during regular pregnancy monitoring in an outpatient clinic or by a newspaper announcement. Newborns from epileptic women with fetal monotherapy carbamazepine exposure during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Newborns from epileptic women with fetal monotherapy lamotrigine exposure during pregnancy.
9 / 8 Study design partly completed with a previous article of Videman 2016.
Videman (Carbamazepine) (Controls unexposed, disease free), 2016 Finland
2009 - 2013
All pregnant women with epilepsy (PWE) treated with antiepileptic drugs living in Helsinki between the study period. Pregnant women with no antiepileptic drug or other brain-acting medication was recruited by a nurse during regular pregnancy monitoring in an outpatient clinic or by a newspaper announcement. Newborns from epileptic women with fetal monotherapy carbamazepine exposure during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Newborns from women with no antiepileptic drug or other brain-acting medication.
9 / 67 Study design partly completed with a previous article of Videman 2016.
Viinikainen (Carbamazepine) (Controls unexposed, disease free) a, 2006 Finland
1989 - 2000
24,778 singleton pregnancies in 16,598 women and 179 of these were pregnancies of women with epilepsy followed up during the pregnancy by the Department of Neurology and gave birth in the hospital. Pregnancies of mothers who had active epilepsy and were using carbamazepine in monotherapy before conception and through the whole pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Pregnancies of mothers without epilepsy and unexposed to antiepileptic drugs.
72 / 24778 Multiple pregnancies and pregnancies with evident neonatal chromosomal abnormalities were excluded.
Viinikainen (Carbamazepine) (Controls unexposed, sick) a, 2006 Finland
1989 - 2000
24,778 singleton pregnancies in 16,598 women and 179 of these were pregnancies of women with epilepsy followed up during the pregnancy by the Department of Neurology and gave birth in the hospital. Pregnancies of mothers who had active epilepsy and were using carbamazepine in monotherapy before conception and through the whole pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Pregnancies of mothers who reported having previous history of epilepsy but no need for antiepileptic drugs at the time of the pregnancy.
72 / 52 Multiple pregnancies and pregnancies with evident neonatal chromosomal abnormalities were excluded.
Viinikainen (Carbamazepine) b, 2006 Finland
1989 - 2000
Women with epilepsy who had given birth between the study period in the area of the Kuopio University Hospital. Pregnancies in which the mother had used carbamazepine during conception and throughout pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Pregnancies in which the mother reported having previous history of epilepsy but had not needed antiepileptic drugs during pregnancy.
13 / 13 None evident malformations and any other causes for possible neurological dysfunctions, e.g. signs suggestive for chromosomal or metabolic diseases were found. The evaluators were blinded. Partly completed with Eriksson 2005.
Vinten (Carbamazepine), 2005 UK
Not specified.
Women with a diagnosis of epilepsy who had children aged between 6 and 16 years recruited from specialist epilepsy clinics and obstetric clinics from the Liverpool and Manchester region. Children born to epileptic mothers on carbamazepine monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Children born to epileptic mothers not on antiepileptic medication during their pregnancy.
52 / 83 Repeat population groups and the same data are already obtained in Adab 2004 for all the neurodevelopmental outcomes except the IQ score within the extremely low range (IQ<69).
Waters (Carbamazepine) (Controls unexposed, disease free), 1994 USA
1987 - 1990
Women with epilepsy in a high risk obstetric clinic. Infants born to epileptic mothers exposed to carbamazepine during the first trimester. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Infants born to nonepileptic mothers selected from a computer-generated list of all women who gave birth in the same facility during this period.
33 / 355 Mothers who abused alcohol and other drugs were excluded from both patient ad control groups.
Waters (Carbamazepine) (Controls unexposed, sick), 1994 USA
1987 - 1990
Women with epilepsy in a high risk obstetric clinic. Infants born to epileptic mothers exposed to carbamazepine during the first trimester. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Pregnancies in women with epilepsy in which there was no exposure to antiepileptic drugs.
33 / 15 Mothers who abused alcohol and other drugs were excluded from both patient ad control groups.
Wide (Carbamazepine), 2000 Sweden
1985 - 1995
Children born to mothers with epilepsy ascertain in early pregnancy who were treated with antiepileptic drugs from conception and monitor throughout pregnancy. First-born infants whose epileptic mothers were continuously treated with carbamazepine monotherapy from conception throughout pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed (general population or NOS)
Children born in the same hospital within 2 days of the study subjects of mothers not treated with antiepileptic drugs.
39 / 87 Sex-matched control infants were found for 69 of 87 (87 of 100) subjects, but the other matching criteria were fulfilled for the total study group.
Wiggs (Carbamazepine), 2020 Sweden
1996 - 2011
Children born in Sweden during the study period and to women with epilepsy any time before childbirth. Children whose epileptic mothers reported use of carbamazepine monotherapy in the first trimester (77% were found to have filled prescriptions later in pregnancy: second or third trimester). (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, sick
Children whose epileptic mothers reported no use of antiseizure medications.
-9 / 11298 Children who were multiples were dropped. Crude data are not specified for monotherapy exposure.
Wood (Carbamazepine), 2015 Australia
2007 - 2010
Women with epilepsy and their children (aged 6–8 years) exposed in utero with antiepileptic drugs were identified through the Australian Pregnancy Register for Women on Antiepileptic Medication (APR). Children of women with epilepsy exposed to carbamazepine in monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). exposed to other treatment, sick
Children of women with epilepsy exposed to lamotrigine in monotherapy during pregnancy.
34 / 9 Children with major birth defects or a diagnosis of epilepsy were excluded, as these conditions are known risk factors for autism spectrum disorders. Child's IQ results are already reported by the publication of Nadebaum 2011.
Yerby (Carbamazepine), 1992 USA
Not specified.
Women with a diagnosis of epilepsy determined by a neurologist, antiepileptic drug use, and active planning for pregnancy or early (first trimester) pregnancy. Infants of mothers with epilepsy treated by carbamazepine monotherapy during pregnancy. (This is a subgroup of exposure among the whole exposed group considered in the study). unexposed, disease free
Infants of women without a chronic illness or a personal or family history of epilepsy.
19 / 46 Women were excluded if they had another chronic illness and were not compliant.

Case-control studies (cohort)

Study Country
Study period
Case Control Sample size Rmk
Arteaga-Vázquez (Carbamazepine), 2012 Mexico
1978 - 2010
Newborn with one or more congenital malformations. Newborn control without congenital malformations which is the birth following the newborn with congenital malformations of the same sex born at the same hospital. 71 / 95
Bànhidy (Carbamazepine), 2011 Hungary
1980 - 1996
Children affected with congenital abnormalities and who had mothers with medically recorded epilepsy. Newborn infants without congenital abnormality and who had mothers with medically recorded epilepsy. 95 / 90 Malformations caused by major mutant genes or chromosomal aberrations with preconceptional origin were excluded. Exposure period completed with Czeizel 1992. Czeizel 1992 congenital abnormalities results are completely overlapped by this publication.
Czeizel (Carbamazepine) (Mixed indications), 1992 Hungary
1980 - 1987
Children affected with congenital abnormalities born from treated or untreated mothers. Children without congenital abnormalities born from treated or untreated mothers. 100 / 54 3 women were treated with carbamazepine for migraine. The study design was partly completed thanks to the reference [6] cited in the publication. All congenital abnormalities except spina bifida are overlapped by the publication of Bànhidy 2011.
Jentink (Carbamazepine), 2010 Europe
1995 - 2005
All live births, fetal deaths from 20 weeks’ gestation, and terminations of pregnancy after prenatal diagnosis, non-chromosomal and non-monogenic, with at least one of the five major congenital malformations under study. Live births, fetal deaths from 20 weeks’ gestation, and terminations of pregnancy after prenatal diagnosis that involved major malformations other than the five malformations under study. 11790 / 69883
Källén (Carbamazepine), 1994 Sweden
1973 - 1991
Infants with spina bifida. Infants whose mothers had epilepsy and were matched. 9 / 18
Thomas a (Carbamazepine), 2008 India
1998 - 2004
Infants with cardiac malformation defined as any major malformation of the heart or intrathoracic great vessels that is actually or potentially of functional significance. Infants without cardiac malformation. 36 / 426 Completely overlapped with Thomas et al., 2021.

master protocol