Carbamazepine (Epilepsy)

Small for gestational age (weight)

R analysis

id	Study	Lib. in paper	Exposition period	Study type All studies Case control excluded Only case control	Control type	Tags	OR 95%CI	x1/n1 x0/n0	no cases	no exposed	ROB	Ref.
S15365 R63209	Bromley (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2023	Small for gestation (calculated using gender-specific scales)	during pregnancy (anytime or not specified)	prospective cohort	exposed to other treatment, sick excluded	Adjustment: No	0.28 [0.03;2.20] ^C excluded (control group)	1/27 13/106	14	27		ref
S15366 R63222	Bromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023	Small for gestation (calculated using gender-specific scales)	during pregnancy (anytime or not specified)	prospective cohort	unexposed, sick	Adjustment: No	0.20 [0.02;1.59] ^C	1/27 13/80	14	27		ref
S12539 R47229	Dreier (Carbamazepine), 2021	Small for gestational age (birth weight below the 10th percentile for GA, sex and country)	during pregnancy (anytime or not specified)	population based cohort retrospective	unexposed, sick	Adjustment: Yes	1.30 [1.12;1.50]	-/2,650 -/-	-	2,650		ref
S8082 R24680	Aydin (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2020	Small for gestational age (birth weight)	throughout pregnancy	retrospective cohort	exposed to other treatment, sick excluded	Adjustment: No	2.60 [0.11;62.58] ^C excluded (control group)	2/15 0/7	2	15		ref
S8074 R24628	Aydin (Carbamazepine) (Controls unexposed, sick), 2020	Small for gestational age (birth weight)	throughout pregnancy	retrospective cohort	unexposed, sick	Adjustment: No	8.60 [0.38;193.87] ^C	2/15 0/22	2	15		ref
S8145 R25041	Cohen (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2019	Small for gestational age (ICD-9 656.5, 764.0, 764.1, 764.9)	early pregnancy	retrospective cohort (claims database)	exposed to other treatment, sick excluded	Adjustment: Yes	1.35 [0.51;3.61] excluded (control group)	-/- -/-	-	-		ref
S8141 R25013	Cohen (Carbamazepine) (Controls unexposed NOS), 2019	Small for gestational age (ICD-9 656.5, 764.0, 764.1, 764.9)	early pregnancy	retrospective cohort (claims database)	unexposed (general population or NOS)	Adjustment: Yes	0.71 [0.35;1.43]	-/- 41,653/1,440,631	41,644	-		ref
S5925 R15073	Artama (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013	Small for gestational age (weight)	during pregnancy (anytime or not specified)	population based cohort retrospective	exposed to other treatment, sick excluded	Adjustment: No	1.54 [0.35;6.65] ^C excluded (control group)	19/1,077 2/173	21	1,077		ref
S5909 R14888	Artama (Carbamazepine) (Controls unexposed, disease free), 2013	Small for gestational age (weight)	during pregnancy (anytime or not specified)	population based cohort retrospective	unexposed, disease free excluded	Adjustment: Yes	0.91 [0.58;1.44] excluded (control group)	19/1,077 14,079/719,509	14,098	1,077		ref
S5917 R14984	Artama (Carbamazepine) (Controls unexposed, sick), 2013	Small for gestational age (weight)	during pregnancy (anytime or not specified)	population based cohort retrospective	unexposed, sick	Adjustment: Yes	0.74 [0.42;1.28]	19/1,077 42/1,793	61	1,077		ref
S6356 R21030	Veiby (Carbamazepine) (Controls exposed to Lamotrigine, sick) b, 2013	Small for gestational age (SGA) birth weight	during pregnancy (anytime or not specified)	prospective cohort	exposed to other treatment, sick excluded	Adjustment: No	3.04 [0.97;9.51] ^C excluded (control group)	9/67 5/103	14	67		ref
S6354 R17339	Veiby (Carbamazepine) (Controls unexposed, disease free) b, 2013	Small for gestational age (SGA) birth weight	during pregnancy (anytime or not specified)	prospective cohort	unexposed, disease free excluded	Adjustment: Yes	2.40 [1.20;4.90] excluded (control group)	9/67 8,017/106,899	8,026	67		ref
S6355 R17335	Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013	Small for gestational age (SGA) birth weight	during pregnancy (anytime or not specified)	prospective cohort	unexposed, sick	Adjustment: No	1.78 [0.80;3.92] ^C	9/67 31/386	40	67		ref
S5511 R17485	Pennell (Carbamazepine), 2012	Small for gestational age (SGA) (at birth)	during pregnancy (anytime or not specified)	prospective cohort	exposed to other treatment, sick	Adjustment: Yes	3.14 [0.91;10.90]	12/93 4/98	16	93		ref
S6621 R18188	Burja (Carbamazepine) (Controls unexposed, disease free), 2006	Small for date (NOS)	during pregnancy (anytime or not specified)	retrospective cohort (registry)	unexposed, disease free excluded	Adjustment: No	1.53 [0.41;5.66] ^C excluded (control group)	3/19 23/211	26	19		ref
S5591 R18142	Burja (Carbamazepine) (Controls unexposed, sick), 2006	Small for date (NOS)	during pregnancy (anytime or not specified)	retrospective cohort (registry)	unexposed, sick	Adjustment: No	5.81 [0.56;60.48] ^C	3/19 1/32	4	19		ref
S8220 R25718	Endo (Carbamazepine) (Controls unexposed, disease free), 2004	Intrauterine growth retardation (NOS)	throughout pregnancy	retrospective cohort	unexposed, disease free excluded	Adjustment: No	2.61 [0.31;21.85] ^C excluded (control group)	1/8 34/656	35	8		ref
S8223 R25763	Endo (Carbamazepine) (Controls unexposed, sick), 2004	Intrauterine growth retardation (NOS)	throughout pregnancy	retrospective cohort	unexposed, sick	Adjustment: No	0.23 [0.00;17.06] ^C	1/8 0/1	1	8		ref
S6298 R17069	Wide (Carbamazepine), 2000	Small for gestationnal age	throughout pregnancy	prospective cohort	unexposed (general population or NOS)	Adjustment: No Matched	0.95 [0.02;49.04] ^C	0/39 0/37	0	39		ref
					Total	10 studies	1.17 [0.79;1.73]		41,782	3,995
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

1: Carbamazepine) (Epilepsy) (Controls unexposed, sick; 2: Carbamazepine; 3: Carbamazepine) (Controls unexposed, sick; 4: Carbamazepine) (Controls unexposed NOS; 5: Carbamazepine) (Controls unexposed, sick; 6: Carbamazepine) (Controls unexposed, sick) ; 7: Carbamazepine; 8: Carbamazepine) (Controls unexposed, sick; 9: Carbamazepine) (Controls unexposed, sick; 10: Carbamazepine;

Sensitivity analysis

Publication bias and p-hacking diagnosis

funnel plot

Asymetry test p-value = 0.8362 (by Egger's regression)

slope=0.2402 (0.1193); intercept=-0.1172 (0.5485); t=0.2136; p=0.8362

p values plot

Sub-groups analysis using all included studies

excluded 8220, 6621, 5925, 5909, 6356, 6354, 8145, 8082, 15365

S15365 R63209	Bromley (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2023	Small for gestation (calculated using gender-specific scales) (96)	during pregnancy (anytime or not specified)	exposed to other treatment, sick	0.28 [0.03;2.20]	1/27 13/106
S15366 R63222	Bromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023	Small for gestation (calculated using gender-specific scales) (96)	during pregnancy (anytime or not specified)	unexposed, sick	0.20 [0.02;1.59]	1/27 13/80
S12539 R47229	Dreier (Carbamazepine), 2021	Small for gestational age (birth weight below the 10th percentile for GA, sex and country) (96)	during pregnancy (anytime or not specified)	unexposed, sick	1.30 [1.12;1.50]	-9/2650 -9/-9
S8082 R24680	Aydin (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2020	Small for gestational age (birth weight) (96)	throughout pregnancy	exposed to other treatment, sick	2.60 [0.11;62.58]	2/15 0/7
S8074 R24628	Aydin (Carbamazepine) (Controls unexposed, sick), 2020	Small for gestational age (birth weight) (96)	throughout pregnancy	unexposed, sick	8.60 [0.38;193.87]	2/15 0/22
S8145 R25041	Cohen (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2019	Small for gestational age (ICD-9 656.5, 764.0, 764.1, 764.9) (96)	early pregnancy	exposed to other treatment, sick	1.35 [0.51;3.61]	-9/-9 -9/-9
S8141 R25013	Cohen (Carbamazepine) (Controls unexposed NOS), 2019	Small for gestational age (ICD-9 656.5, 764.0, 764.1, 764.9) (96)	early pregnancy	unexposed (general population or NOS)	0.71 [0.35;1.43]	-9/-9 41653/1440631
S5925 R15073	Artama (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013	Small for gestational age (weight) (96)	during pregnancy (anytime or not specified)	exposed to other treatment, sick	1.54 [0.35;6.65]	19/1077 2/173
S5909 R14888	Artama (Carbamazepine) (Controls unexposed, disease free), 2013	Small for gestational age (weight) (96)	during pregnancy (anytime or not specified)	unexposed, disease free	0.91 [0.58;1.44]	19/1077 14079/719509
S5917 R14984	Artama (Carbamazepine) (Controls unexposed, sick), 2013	Small for gestational age (weight) (96)	during pregnancy (anytime or not specified)	unexposed, sick	0.74 [0.42;1.28]	19/1077 42/1793
S6356 R21030	Veiby (Carbamazepine) (Controls exposed to Lamotrigine, sick) b, 2013	Small for gestational age (SGA) birth weight (96)	during pregnancy (anytime or not specified)	exposed to other treatment, sick	3.04 [0.97;9.51]	9/67 5/103
S6354 R17339	Veiby (Carbamazepine) (Controls unexposed, disease free) b, 2013	Small for gestational age (SGA) birth weight (96)	during pregnancy (anytime or not specified)	unexposed, disease free	2.40 [1.20;4.90]	9/67 8017/106899
S6355 R17335	Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013	Small for gestational age (SGA) birth weight (96)	during pregnancy (anytime or not specified)	unexposed, sick	1.78 [0.80;3.92]	9/67 31/386
S5511 R17485	Pennell (Carbamazepine), 2012	Small for gestational age (SGA) (at birth) (96)	during pregnancy (anytime or not specified)	exposed to other treatment, sick	3.14 [0.91;10.90]	12/93 4/98
S6621 R18188	Burja (Carbamazepine) (Controls unexposed, disease free), 2006	Small for date (NOS) (96)	during pregnancy (anytime or not specified)	unexposed, disease free	1.53 [0.41;5.66]	3/19 23/211
S5591 R18142	Burja (Carbamazepine) (Controls unexposed, sick), 2006	Small for date (NOS) (96)	during pregnancy (anytime or not specified)	unexposed, sick	5.81 [0.56;60.48]	3/19 1/32
S8220 R25718	Endo (Carbamazepine) (Controls unexposed, disease free), 2004	Intrauterine growth retardation (NOS) (96)	throughout pregnancy	unexposed, disease free	2.61 [0.31;21.85]	1/8 34/656
S8223 R25763	Endo (Carbamazepine) (Controls unexposed, sick), 2004	Intrauterine growth retardation (NOS) (96)	throughout pregnancy	unexposed, sick	0.23 [0.00;17.06]	1/8 0/1
S6298 R17069	Wide (Carbamazepine), 2000	Small for gestationnal age (96)	throughout pregnancy	unexposed (general population or NOS)	0.95 [0.02;49.04]	0/39 0/37