Carbamazepine (Epilepsy)

ADHD (Attention deficit hyperactivity disorder): Diagnosis/Risk

id	Study   Auto Dreier (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2023Dreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023Wiggs (Carbamazepine), 2020Huber-Mollema (Carbamazepine), 2019Bromley (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013Bromley (Carbamazepine) (Controls unexposed, disease free), 2013Bromley (Carbamazepine) (Controls unexposed, sick), 2013Cohen (Carbamazepine), 2013Veiby (Carbamazepine) (Controls exposed to Lamotrigine, sick) b, 2013Veiby (Carbamazepine) (Controls unexposed, disease free) b, 2013Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013Viinikainen (Carbamazepine) b, 2006	Lib. in paper	Exposition period  Auto during pregnancy (anytime or not specified)1st trimester2nd trimester3rd trimester2nd and/or 3rd trimesterthroughout pregnancyearly pregnancydays before deliverylate pregnancypreconception-onlypericonceptionalpreconceptional for kinetic reasonat least 1st trimester3 months (or more) before pregnancy or during pregnancy1st and 2nd trimester3 months or more before pregnancy or1st trimester	Study type  All studies Case control excluded Only case control	Control type    Auto unexposed (general population or NOS)unexposed, sickunexposed, disease freeexposed to other treatment, sicknot specifiedwhatever (meta-analysis)	Tags	OR 95%CI	x1/n1 x0/n0	no cases	no exposed	ROB	Ref.
S15868 R65361	Dreier (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2023	Attention-deficit/hyperactivity disorder (ADHD) - 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	1.89 [1.41;2.53] C excluded (control group)	89/2,665   95/5,288	184	2,665		ref
S15869 R65377	Dreier (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023	Attention-deficit/hyperactivity disorder (ADHD) - 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	1.05 [0.81;1.37]	89/2,665   528/22,203	617	2,665		ref
S8024 R46611	Wiggs (Carbamazepine), 2020	Attention-deficit/hyperactivity disorder (after 2 years of age)	at least 1st trimester	population based cohort retrospective	unexposed, sick	Adjustment: Yes	1.18 [0.91;1.52]	-/-   -/11,298	-	-		ref
S7510 R46610	Huber-Mollema (Carbamazepine), 2019	Diagnosis of ADHD	throughout pregnancy	prospective cohort	exposed to other treatment, sick	Adjustment: No	0.95 [0.18;5.12] C	2/37   5/88	7	37		ref
S6661 R46606	Bromley (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013	Attention deficit hyperactivity disorder (at 6 years old)	during pregnancy (anytime or not specified)	prospective cohort	exposed to other treatment, sick excluded	Adjustment: No	1.82 [0.07;46.28] C excluded (control group)	1/50   0/30	1	50		ref
S6660 R46607	Bromley (Carbamazepine) (Controls unexposed, disease free), 2013	Attention deficit hyperactivity disorder (at 6 years old)	during pregnancy (anytime or not specified)	prospective cohort	unexposed, disease free excluded	Adjustment: No	13.21 [0.53;329.15] C excluded (control group)	1/50   0/214	1	50		ref
S5486 R46608	Bromley (Carbamazepine) (Controls unexposed, sick), 2013	Attention deficit hyperactivity 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
S5542 R46609	Cohen (Carbamazepine), 2013	Children with either ADHD inattentive OR combined types > 1 SD (from the Attention Problems and Hyperactivity scales of the BASC) (Both Parent and Teacher)	during pregnancy (anytime or not specified)	prospective cohort	exposed to other treatment, sick	Adjustment: No	0.96 [0.22;4.25] C	4/32   4/31	8	32		ref
S6356 R46612	Veiby (Carbamazepine) (Controls exposed to Lamotrigine, sick) b, 2013	ADHD symptoms ≥ 2SD (at 36 months) (Specific checklist) (Parent-reported)	during pregnancy (anytime or not specified)	prospective cohort	exposed to other treatment, sick excluded	Adjustment: No	0.94 [0.15;6.00] C excluded (control group)	2/31   3/44	5	31		ref
S6354 R46613	Veiby (Carbamazepine) (Controls unexposed, disease free) b, 2013	ADHD symptoms ≥ 2SD (at 36 months) (Specific checklist) (Parent-reported)	during pregnancy (anytime or not specified)	prospective cohort	unexposed, disease free excluded	Adjustment: No	2.00 [0.50;8.60] excluded (control group)	2/31   1,743/43,571	1,745	31		ref
S6355 R46614	Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013	ADHD symptoms ≥ 2SD (at 36 months) (Specific checklist) (Parent-reported)	during pregnancy (anytime or not specified)	prospective cohort	unexposed, sick	Adjustment: No	2.59 [0.45;14.78] C	2/31   4/154	6	31		ref
S5831 R46615	Viinikainen (Carbamazepine) b, 2006	Conners' Teacher Rating Scale Global Index scores >1 SD	throughout pregnancy	prospective cohort	unexposed, sick	Adjustment: No	0.15 [0.01;3.50] C	0/12   2/11	2	12		ref
					Total	7 studies	1.11 [0.93;1.33]		641	2,827
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

Sensitivity analysis

Publication bias and p-hacking diagnosis

Sub-groups analysis using all included studies

excluded 6661, 6660, 6356, 6354, 15868