Carbamazepine (Epilepsy)

Severe cognitive developmental delay (Mental retardation) (> 6 years old)

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.
S15868
R65354
Dreier (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2023 Intellectual disability - Corresponding ICD-10 F-chapter - Up to 22 years of age during pregnancy (anytime or not specified) population based cohort propective exposed to other treatment, sick excluded Adjustment: No 2.12 [1.32;3.39] C
excluded (control group)
36/2,665   34/5,288 70 2,665
ref
S15869
R65370
Dreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Intellectual disability - Corresponding ICD-10 F-chapter - Up to 22 years of age during pregnancy (anytime or not specified) population based cohort propective unexposed, sick Adjustment: Yes 1.11 [0.73;1.70] 36/2,665   184/22,203 220 2,665
ref
S386
R17415
Meador (Carbamazepine), 2013 IQ <70 (DAS) (at 6 years old) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick Adjustment: Yes 3.71 [0.15;92.65] C 1/61   0/74 1 61
ref
S6106
R15984
Titze (Carbamazepine) (Controls unexposed, disease free), 2008 Learning disability (IQ<70) (German versions of the revised Wechsler Intelligence Scales for children and for adults) during pregnancy (anytime or not specified) prospective cohort unexposed, disease free excluded Adjustment: No Matched 13.86 [0.24;809.27] C
excluded (control group)
0/4   0/49 0 4
ref
S6112
R15987
Titze (Carbamazepine) (Controls unexposed, sick), 2008 Learning disability (IQ<70) (German versions of the revised Wechsler Intelligence Scales for children and for adults) during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No 1.10 [0.04;33.38] C 0/4   1/13 1 4
ref
S5831
R14433
Viinikainen (Carbamazepine) b, 2006 Full Scale IQ (FIQ) < 2SD Wechsler Intelligence Scale for Children (WISC III) throughout pregnancy prospective cohort unexposed, sick Adjustment: No 1.00 [0.02;54.47] C 0/13   0/13 0 13
ref
S5560
R19152
Vinten (Carbamazepine), 2005 IQ score <69 Wechsler Intelligence Scale for Children (WISC III) (Aged between 6 and 16 years) during pregnancy (anytime or not specified) retrospective cohort unexposed, sick Adjustment: No 1.03 [0.28;3.83] C 4/52   6/80 10 52
ref
S7236
R20865
Gaily (Carbamazepine) (Controls unexposed, disease free), 2004 Mental retardation (Verbal and nonverbal IQ <70) 2nd and/or 3rd trimester prospective cohort unexposed, disease free excluded Adjustment: No 0.54 [0.06;5.29] C
excluded (control group)
1/86   3/141 4 86
ref
S5557
R20856
Gaily (Carbamazepine) (Controls unexposed, sick), 2004 Mental retardation (Verbal and nonverbal IQ <70) 2nd and/or 3rd trimester prospective cohort unexposed, sick Adjustment: No 0.25 [0.02;2.87] C 1/86   2/45 3 86
ref
Total 6 studies 1.08 [0.73;1.59] 235 2,881
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 Dreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023Dreier, 2023 1 1.11[0.73; 1.70]2202,66585%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Meador (Carbamazepine), 2013Meador, 2013 2 3.71[0.15; 92.65]1611%ROB confusion: moderateROB selection: lowROB classification: lowROB missing: moderateROB mesure: lowROB reporting: low Titze (Carbamazepine) (Controls unexposed, sick), 2008Titze, 2008 3 1.10[0.04; 33.38]141%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: moderateROB mesure: moderateROB reporting: moderate Viinikainen (Carbamazepine) b, 2006Viinikainen, 2006 4 1.00[0.02; 54.47]0131%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: moderateROB mesure: lowROB reporting: moderate Vinten (Carbamazepine), 2005Vinten, 2005 5 1.03[0.28; 3.83]10529%ROB confusion: criticalROB selection: criticalROB classification: lowROB missing: criticalROB mesure: lowROB reporting: moderate Gaily (Carbamazepine) (Controls unexposed, sick), 2004Gaily, 2004 6 0.25[0.02; 2.87]3863%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: criticalROB mesure: lowROB reporting: moderate Total (6 studies) I2 = 0% 1.08[0.73; 1.59]2352,8810.210.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Carbamazepine) (Epilepsy) (Controls unexposed, sick; 2: Carbamazepine; 3: Carbamazepine) (Controls unexposed, sick; 4: Carbamazepine) ; 5: Carbamazepine; 6: Carbamazepine) (Controls unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.08[0.73; 1.59]2352,8810%NADreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Meador (Carbamazepine), 2013 Titze (Carbamazepine) (Controls unexposed, sick), 2008 Viinikainen (Carbamazepine) b, 2006 Vinten (Carbamazepine), 2005 Gaily (Carbamazepine) (Controls unexposed, sick), 2004 6 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 1.06[0.72; 1.57]2342,8200%NADreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Titze (Carbamazepine) (Controls unexposed, sick), 2008 Viinikainen (Carbamazepine) b, 2006 Vinten (Carbamazepine), 2005 Gaily (Carbamazepine) (Controls unexposed, sick), 2004 5 exposed to other treatment, sickexposed to other treatment, sick 3.71[0.15; 92.65]161 -NAMeador (Carbamazepine), 2013 1 Tags Adjustment   - No  - No 0.79[0.27; 2.28]141550%NATitze (Carbamazepine) (Controls unexposed, sick), 2008 Viinikainen (Carbamazepine) b, 2006 Vinten (Carbamazepine), 2005 Gaily (Carbamazepine) (Controls unexposed, sick), 2004 4   - Yes  - Yes 1.13[0.75; 1.72]2212,7260%NADreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Meador (Carbamazepine), 2013 2 All studiesAll studies 1.08[0.73; 1.59]2352,8810%NADreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Meador (Carbamazepine), 2013 Titze (Carbamazepine) (Controls unexposed, sick), 2008 Viinikainen (Carbamazepine) b, 2006 Vinten (Carbamazepine), 2005 Gaily (Carbamazepine) (Controls unexposed, sick), 2004 60.110.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-4.84.92.4480.000Dreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023Meador (Carbamazepine), 2013Titze (Carbamazepine) (Controls unexposed, sick), 2008Viinikainen (Carbamazepine) b, 2006Vinten (Carbamazepine), 2005Gaily (Carbamazepine) (Controls unexposed, sick), 2004

Asymetry test p-value = 0.7640 (by Egger's regression)

slope=0.1191 (0.1919); intercept=-0.1267 (0.3941); t=0.3214; p=0.7640

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 7236, 6106, 15868

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.74[0.08; 36.67]49046%NATitze (Carbamazepine) (Controls unexposed, disease free), 2008 Gaily (Carbamazepine) (Controls unexposed, disease free), 2004 2 unexposed, sick controlsunexposed, sick controls 1.06[0.72; 1.57]2342,8200%NADreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Titze (Carbamazepine) (Controls unexposed, sick), 2008 Viinikainen (Carbamazepine) b, 2006 Vinten (Carbamazepine), 2005 Gaily (Carbamazepine) (Controls unexposed, sick), 2004 5 exposed to other treatment, sick controlsexposed to other treatment, sick controls 2.14[1.34; 3.41]712,7260%NADreier (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2023 Meador (Carbamazepine), 2013 20.510.01.0