Clonazepam (Psy and Mixed indications) updated on 02-10-2025

Microcephaly / Small head circumference for gestational age

R analysis
id Study   Lib. in paper Exposition period    Study type  Control type 
 
Tags OR 95%CI x1/n1 x0/n0 no cases no exposed ROB Ref.
S17718
R74733
Christensen (Indications other than epilepsy), 2024 Microcephaly (z-score for head circumference ≤3rd percentile for gestational week, sex, and country (including newborns with congenital malformations)) during pregnancy (anytime or not specified) population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes BZD Coexposure: No (among antiseizure medications) Indication BZD: Psychiatric diseases (depression, anxiety, ...) 1.26 [0.94;1.69] 52/1,019   133,324/4,445,621 133,376 1,019
ref
S15651
R64608
Blotière (Indications other than epilepsy), 2019 Microcephaly (until 24 months of age, identifiable by: Q02; brain MRI; according to the EUROCAT definition) 1st trimester retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No BZD Coexposure: No (among antiseizure medications) 10.20 [2.10;30.00] 3/980   438/1,875,733 441 980
ref
S17865
R75466
Eros (Indications NOS), 2002 Microcephaly during pregnancy (anytime or not specified) case control unexposed (general population or NOS) Adjustment: No BZD Coexposure: Yes (with psychiatric (ATD and/or psychotropics) medications) Matched no data 0/-   -/- - -
ref
Total 3 studies 3.19 [0.47;21.76] 133,817 1,999
x1: number of endpoints among exposed, n1: number of exposed; x0: number of endpoints among non exposed, n0: number of non exposed; C: calculated odds ratio from numbers of events and effectives

Forest plot

StudyTE95% CIn casesn exposedweightROBABCDEF Christensen (Indications other than epilepsy), 2024Christensen, 2024 1 1.26[0.94; 1.69]133,3761,01956%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: lowROB mesure: unclearROB reporting: moderate Blotière (Indications other than epilepsy), 2019Blotière, 2019 2 10.20[2.10; 30.00]44198044%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Eros (Indications NOS), 2002Eros, 2002 3 1.00[0.00; 62.30]--0%ROB confusion: criticalROB selection: criticalROB classification: criticalROB missing: moderateROB mesure: criticalROB reporting: unclear Total (3 studies) I2 = 78% 3.19[0.47; 21.76]133,8171,9990.550.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Indications other than epilepsy; 2: Indications other than epilepsy; 3: Indications NOS;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 3.23[0.42; 24.81]133,8171,99989%NAChristensen (Indications other than epilepsy), 2024 Blotière (Indications other than epilepsy), 2019 2 case control studiescase control studies Eros (Indications NOS), 2002 1 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 3.19[0.47; 21.76]133,8171,99978%NAChristensen (Indications other than epilepsy), 2024 Blotière (Indications other than epilepsy), 2019 Eros (Indications NOS), 2002 3 Tags Adjustment   - No  - No 10.20[2.70; 38.55]4419800%NABlotière (Indications other than epilepsy), 2019 Eros (Indications NOS), 2002 2   - Yes  - Yes 1.26[0.94; 1.69]133,3761,019 -NAChristensen (Indications other than epilepsy), 2024 1 BZD Coexposure   - No (among antiseizure medications)  - No (among antiseizure medications) 3.23[0.42; 24.81]133,8171,99989%NAChristensen (Indications other than epilepsy), 2024 Blotière (Indications other than epilepsy), 2019 2   - Yes (with psychiatric (ATD and/or p ...  - Yes (with psychiatric (ATD and/or psychotropics) medications) Eros (Indications NOS), 2002 1 Indication BZD   - Psychiatric diseases (depression, a ...  - Psychiatric diseases (depression, anxiety, ...) 1.26[0.94; 1.69]133,3761,019 -NAChristensen (Indications other than epilepsy), 2024 1 MatchedMatched Eros (Indications NOS), 2002 1 All studiesAll studies 3.19[0.47; 21.76]133,8171,99978%NAChristensen (Indications other than epilepsy), 2024 Blotière (Indications other than epilepsy), 2019 Eros (Indications NOS), 2002 30.550.01.0

Publication bias and p-hacking diagnosis

funnel plot

Funnel plot not drawn. Less than 3 points.

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

not enought points

p values plot

Funnel plot not drawn. Less than 3 points.

Sub-groups analysis using all included studies

excluded

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 3.23[0.42; 24.81]133,8171,99989%NAChristensen (Indications other than epilepsy), 2024 Blotière (Indications other than epilepsy), 2019 20.510.01.0