Carbamazepine (Epilepsy)

Low Apgar score (< 7) (at 1 min)

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.
S5925
R15066
Artama (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013 1-min Apgar <7 3rd trimester population based cohort retrospective exposed to other treatment, sick excluded Adjustment: No 0.67 [0.32;1.42] C
excluded (control group)
36/904   9/154 45 904
ref
S5909
R14881
Artama (Carbamazepine) (Controls unexposed, disease free), 2013 1-min Apgar <7 3rd trimester population based cohort retrospective unexposed, disease free excluded Adjustment: Yes 1.04 [0.74;1.45]
excluded (control group)
36/904   27,939/689,482 27,975 904
ref
S5917
R14977
Artama (Carbamazepine) (Controls unexposed, sick), 2013 1-min Apgar <7 3rd trimester population based cohort retrospective unexposed, sick Adjustment: Yes 1.06 [0.70;1.61] 36/904   69/1,708 105 904
ref
S5511
R17499
Pennell (Carbamazepine), 2012 Apgar score (at 1 minute < 7) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick Adjustment: No 2.55 [0.76;8.60] C 9/91   4/97 13 91
ref
S8220
R25729
Endo (Carbamazepine) (Controls unexposed, disease free), 2004 Apgar score (<8 at 1min) throughout pregnancy retrospective cohort unexposed, disease free excluded Adjustment: No 0.71 [0.09;5.89] C
excluded (control group)
1/8   47/280 48 8
ref
S8223
R25774
Endo (Carbamazepine) (Controls unexposed, sick), 2004 Apgar score (<8 at 1min) throughout pregnancy retrospective cohort unexposed, sick Adjustment: No 0.23 [0.00;17.06] C 1/8   0/1 1 8
ref
S6823
R19277
Van der Pol (Carbamazepine) (Controls unexposed, disease free), 1991 Apgar scores (1 minute <7) throughout pregnancy prospective cohort unexposed, disease free excluded Adjustment: No Matched 1.00 [0.11;9.51] C
excluded (control group)
1/11   5/55 6 11
ref
S6825
R19327
Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 Apgar scores (1 minute <7) throughout pregnancy prospective cohort unexposed, sick Adjustment: No 2.10 [0.12;37.12] C 1/11   1/22 2 11
ref
Total 4 studies 1.16 [0.79;1.71] 121 1,014
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 Artama (Carbamazepine) (Controls unexposed, sick), 2013Artama, 2013 1 1.06[0.70; 1.61]10590487%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Pennell (Carbamazepine), 2012Pennell, 2012 2 2.55[0.76; 8.60]139110%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Endo (Carbamazepine) (Controls unexposed, sick), 2004Endo, 2004 3 0.23[0.00; 17.06]181%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991Van der Pol, 1991 4 2.10[0.12; 37.12]2112%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Total (4 studies) I2 = 0% 1.16[0.79; 1.71]1211,0140.210.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Carbamazepine) (Controls unexposed, sick; 2: Carbamazepine; 3: Carbamazepine) (Controls unexposed, sick; 4: Carbamazepine) (Controls unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.16[0.79; 1.71]1211,0140%NAArtama (Carbamazepine) (Controls unexposed, sick), 2013 Pennell (Carbamazepine), 2012 Endo (Carbamazepine) (Controls unexposed, sick), 2004 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 4 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 1.06[0.70; 1.60]1089230%NAArtama (Carbamazepine) (Controls unexposed, sick), 2013 Endo (Carbamazepine) (Controls unexposed, sick), 2004 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 3 exposed to other treatment, sickexposed to other treatment, sick 2.55[0.76; 8.60]1391 -NAPennell (Carbamazepine), 2012 1 Tags Adjustment   - No  - No 2.13[0.72; 6.29]161100%NAPennell (Carbamazepine), 2012 Endo (Carbamazepine) (Controls unexposed, sick), 2004 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 3   - Yes  - Yes 1.06[0.70; 1.61]105904 -NAArtama (Carbamazepine) (Controls unexposed, sick), 2013 1 All studiesAll studies 1.16[0.79; 1.71]1211,0140%NAArtama (Carbamazepine) (Controls unexposed, sick), 2013 Pennell (Carbamazepine), 2012 Endo (Carbamazepine) (Controls unexposed, sick), 2004 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 40.110.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-5.25.32.6350.000Artama (Carbamazepine) (Controls unexposed, sick), 2013Pennell (Carbamazepine), 2012Endo (Carbamazepine) (Controls unexposed, sick), 2004Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991

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

not enought points

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 6823, 8220, 5925, 5909

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.03[0.74; 1.43]28,0299230%NAArtama (Carbamazepine) (Controls unexposed, disease free), 2013 Endo (Carbamazepine) (Controls unexposed, disease free), 2004 Van der Pol (Carbamazepine) (Controls unexposed, disease free), 1991 3 unexposed, sick controlsunexposed, sick controls 1.06[0.70; 1.60]1089230%NAArtama (Carbamazepine) (Controls unexposed, sick), 2013 Endo (Carbamazepine) (Controls unexposed, sick), 2004 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 3 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.20[0.33; 4.39]5899570%NAArtama (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013 Pennell (Carbamazepine), 2012 20.510.01.0