Carbamazepine (Epilepsy)

Neuro-developmental disorders (as a whole)

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.
S12741
R48081
Bjørk (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2022 Neurodevelopmental Disorder (ND): any diagnoses of autism spectrum disorder (F84.0, F84.1, F84.5) or intellectual disability (F70, F71, F72, F73) plus F84.3, F84.4, F84.8, F84.9, F79 (between 6.1 and 7.9 years old) during pregnancy (anytime or not specified) population based cohort retrospective exposed to other treatment, sick excluded Adjustment: No 1.57 [1.13;2.19] C
excluded (control group)
65/2,609   81/5,073 146 2,609
ref
S12742
R48084
Bjørk (Carbamazepine) (Controls unexposed, NOS), 2022 Neurodevelopmental Disorder (ND): any diagnoses of autism spectrum disorder (F84.0, F84.1, F84.5) or intellectual disability (F70, F71, F72, F73) plus F84.3, F84.4, F84.8, F84.9, F79 (between 6.1 and 7.9 years old) during pregnancy (anytime or not specified) population based cohort retrospective unexposed (general population or NOS) excluded Adjustment: No 1.64 [1.29;2.10] C
excluded (control group)
65/2,609   68,295/4,463,879 68,360 2,609
ref
S12743
R48087
Bjørk (Carbamazepine) (Controls unexposed, sick), 2022 Neurodevelopmental Disorder (ND): any diagnoses of autism spectrum disorder (F84.0, F84.1, F84.5) or intellectual disability (F70, F71, F72, F73) plus F84.3, F84.4, F84.8, F84.9, F79 (between 6.1 and 7.9 years old) during pregnancy (anytime or not specified) population based cohort retrospective unexposed, sick Adjustment: Yes 0.92 [0.68;1.25] 65/2,609   443/21,634 508 2,609
ref
S8129
R24959
Charlton (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2017 Neurodevelopmental disorders (at 6 years old) during pregnancy (anytime or not specified) retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: No 9.38 [0.51;171.34] C
excluded (control group)
5/148   0/122 5 148
ref
S8123
R24953
Charlton (Carbamazepine) (Controls unexposed, disease free), 2017 Neurodevelopmental disorders (at 6 years old) during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, disease free excluded Adjustment: Yes Matched 2.75 [0.92;8.24]
excluded (control group)
5/148   58/6,048 63 148
ref
S8126
R24956
Charlton (Carbamazepine) (Controls unexposed, sick), 2017 Neurodevelopmental disorders (at 6 years old) during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, sick Adjustment: No 1.80 [0.59;5.45] C 5/148   9/472 14 148
ref
S6253
R16658
Arkilo (Carbamazepine), 2015 Abnormal development (At 2 years of age, assessed by developmental specialists) during pregnancy (anytime or not specified) retrospective cohort exposed to other treatment, sick Adjustment: No 2.73 [0.39;18.88] C 3/14   2/22 5 14
ref
S6661
R18415
Bromley (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013 Neurodevelopmental disorder (at 6 years old) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No 0.29 [0.02;3.29] C
excluded (control group)
1/50   2/30 3 50
ref
S6660
R18411
Bromley (Carbamazepine) (Controls unexposed, disease free), 2013 Neurodevelopmental disorder (at 6 years old) during pregnancy (anytime or not specified) prospective cohort unexposed, disease free excluded Adjustment: Yes 1.09 [0.06;7.39]
excluded (control group)
1/50   4/214 5 50
ref
S5486
R18100
Bromley (Carbamazepine) (Controls unexposed, sick), 2013 Neurodevelopmental disorder (at 6 years old) during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No 1.58 [0.06;40.13] C 1/50   0/26 1 50
ref
S6674
R18472
Dean (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2007 Neurodevelopmental disorder (mean age in years: m1=5.08 and m0=1.5) during pregnancy (anytime or not specified) retrospective cohort exposed to other treatment, sick excluded Adjustment: No 2.06 [0.10;41.80] C
excluded (control group)
17/77   0/4 17 77
ref
S5592
R18392
Dean (Carbamazepine) (Controls unexposed, sick), 2007 Neurodevelopmental disorder (mean age in years: m1=5.08 and m0=15.25) during pregnancy (anytime or not specified) retrospective cohort unexposed, sick Adjustment: No 4.06 [1.12;14.73] C 17/77   3/46 20 77
ref
S5831
R14435
Viinikainen (Carbamazepine) b, 2006 Need for educational support throughout pregnancy prospective cohort unexposed, sick Adjustment: No 1.00 [0.12;8.42] C 2/13   2/13 4 13
ref
S5541
R16464
Adab (Carbamazepine), 2004 Any additional educational needs during pregnancy (anytime or not specified) retrospective cohort unexposed, sick Adjustment: No 0.63 [0.30;1.33] 14/61   28/87 42 61
ref
S5545
R19170
Katz (Carbamazepine), 2001 Developmental delay (Based on the DSM-IV-TR criteria) during pregnancy (anytime or not specified) retrospective cohort exposed to other treatment, sick Adjustment: No 1.36 [0.06;33.80] C 4/21   0/3 4 21
ref
S6823
R19285
Van der Pol (Carbamazepine) (Controls unexposed, disease free), 1991 Nonoptimal school career throughout pregnancy prospective cohort unexposed, disease free excluded Adjustment: No Matched 0.22 [0.01;4.05] C
excluded (control group)
0/10   10/54 10 10
ref
S6825
R19335
Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 Nonoptimal school career throughout pregnancy prospective cohort unexposed, sick Adjustment: No 0.16 [0.01;3.18] C 0/10   5/22 5 10
ref
Total 9 studies 1.09 [0.71;1.65] 603 3,003
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 Bjørk (Carbamazepine) (Controls unexposed, sick), 2022Bjørk, 2022 1 0.92[0.68; 1.25]5082,60945%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Charlton (Carbamazepine) (Controls unexposed, sick), 2017Charlton, 2017 2 1.80[0.59; 5.45]1414812%ROB confusion: unclearROB selection: lowROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Arkilo (Carbamazepine), 2015Arkilo, 2015 3 2.73[0.39; 18.88]5144%ROB confusion: criticalROB selection: criticalROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Bromley (Carbamazepine) (Controls unexposed, sick), 2013Bromley, 2013 4 1.58[0.06; 40.13]1502%ROB confusion: criticalROB selection: lowROB classification: lowROB missing: moderateROB mesure: moderateROB reporting: moderate Dean (Carbamazepine) (Controls unexposed, sick), 2007Dean, 2007 5 4.06[1.12; 14.73]20779%ROB confusion: criticalROB selection: criticalROB classification: lowROB missing: criticalROB mesure: criticalROB reporting: moderate Viinikainen (Carbamazepine) b, 2006Viinikainen, 2006 6 1.00[0.12; 8.42]4134%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: moderateROB mesure: lowROB reporting: moderate Adab (Carbamazepine), 2004Adab, 2004 7 0.63[0.30; 1.33]426121%ROB confusion: criticalROB selection: criticalROB classification: lowROB missing: criticalROB mesure: moderateROB reporting: moderate Katz (Carbamazepine), 2001Katz, 2001 8 1.36[0.06; 33.80]4212%ROB confusion: criticalROB selection: criticalROB classification: lowROB missing: lowROB mesure: moderateROB reporting: moderate Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991Van der Pol, 1991 9 0.16[0.01; 3.18]5102%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Total (9 studies) I2 = 20% 1.09[0.71; 1.65]6033,0030.010.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Carbamazepine) (Controls unexposed, sick; 2: Carbamazepine) (Controls unexposed, sick; 3: Carbamazepine; 4: Carbamazepine) (Controls unexposed, sick; 5: Carbamazepine) (Controls unexposed, sick; 6: Carbamazepine) ; 7: Carbamazepine; 8: Carbamazepine; 9: Carbamazepine) (Controls unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.09[0.71; 1.65]6033,00320%NABjørk (Carbamazepine) (Controls unexposed, sick), 2022 Charlton (Carbamazepine) (Controls unexposed, sick), 2017 Arkilo (Carbamazepine), 2015 Bromley (Carbamazepine) (Controls unexposed, sick), 2013 Dean (Carbamazepine) (Controls unexposed, sick), 2007 Viinikainen (Carbamazepine) b, 2006 Adab (Carbamazepine), 2004 Katz (Carbamazepine), 2001 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 9 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 1.06[0.65; 1.73]5942,96832%NABjørk (Carbamazepine) (Controls unexposed, sick), 2022 Charlton (Carbamazepine) (Controls unexposed, sick), 2017 Bromley (Carbamazepine) (Controls unexposed, sick), 2013 Dean (Carbamazepine) (Controls unexposed, sick), 2007 Viinikainen (Carbamazepine) b, 2006 Adab (Carbamazepine), 2004 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 7 exposed to other treatment, sickexposed to other treatment, sick 2.27[0.43; 11.89]9350%NAArkilo (Carbamazepine), 2015 Katz (Carbamazepine), 2001 2 Tags Adjustment   - No  - No 1.30[0.68; 2.51]9539425%NACharlton (Carbamazepine) (Controls unexposed, sick), 2017 Arkilo (Carbamazepine), 2015 Bromley (Carbamazepine) (Controls unexposed, sick), 2013 Dean (Carbamazepine) (Controls unexposed, sick), 2007 Viinikainen (Carbamazepine) b, 2006 Adab (Carbamazepine), 2004 Katz (Carbamazepine), 2001 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 8   - Yes  - Yes 0.92[0.68; 1.25]5082,609 -NABjørk (Carbamazepine) (Controls unexposed, sick), 2022 1 All studiesAll studies 1.09[0.71; 1.65]6033,00320%NABjørk (Carbamazepine) (Controls unexposed, sick), 2022 Charlton (Carbamazepine) (Controls unexposed, sick), 2017 Arkilo (Carbamazepine), 2015 Bromley (Carbamazepine) (Controls unexposed, sick), 2013 Dean (Carbamazepine) (Controls unexposed, sick), 2007 Viinikainen (Carbamazepine) b, 2006 Adab (Carbamazepine), 2004 Katz (Carbamazepine), 2001 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 90.010.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.94.01.9810.000Bjørk (Carbamazepine) (Controls unexposed, sick), 2022Charlton (Carbamazepine) (Controls unexposed, sick), 2017Arkilo (Carbamazepine), 2015Bromley (Carbamazepine) (Controls unexposed, sick), 2013Dean (Carbamazepine) (Controls unexposed, sick), 2007Viinikainen (Carbamazepine) b, 2006Adab (Carbamazepine), 2004Katz (Carbamazepine), 2001Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991

Asymetry test p-value = 0.4315 (by Egger's regression)

slope=-0.1471 (0.2157); intercept=0.4524 (0.5421); t=0.8345; p=0.4315

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 6823, 6674, 6661, 6660, 8129, 8123, 12741, 12742

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.66[1.30; 2.10]68,4382,8170%NABjørk (Carbamazepine) (Controls unexposed, NOS), 2022 Charlton (Carbamazepine) (Controls unexposed, disease free), 2017 Bromley (Carbamazepine) (Controls unexposed, disease free), 2013 Van der Pol (Carbamazepine) (Controls unexposed, disease free), 1991 4 unexposed, sick controlsunexposed, sick controls 1.06[0.65; 1.73]5942,96832%NABjørk (Carbamazepine) (Controls unexposed, sick), 2022 Charlton (Carbamazepine) (Controls unexposed, sick), 2017 Bromley (Carbamazepine) (Controls unexposed, sick), 2013 Dean (Carbamazepine) (Controls unexposed, sick), 2007 Viinikainen (Carbamazepine) b, 2006 Adab (Carbamazepine), 2004 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 7 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.59[1.16; 2.18]1802,9190%NABjørk (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2022 Charlton (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2017 Arkilo (Carbamazepine), 2015 Bromley (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013 Dean (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2007 Katz (Carbamazepine), 2001 60.510.01.0