Phenytoin (Epilepsy)

Low Apgar score (< 7) (at 5 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.
S5922
R15038		 Artama (Phenytoin) (Controls exposed to Lamotrigine, sick), 2013 5-min Apgar <7 3rd trimester population based cohort retrospective exposed to other treatment, sick excluded Adjustment: No 12.24 [0.42;356.65] C
excluded (control group) 		0/2   3/132 3 2
ref
S305
R14807		 Artama (Phenytoin) (Controls unexposed, disease free), 2013 5-min Apgar <7 3rd trimester population based cohort retrospective unexposed, disease free excluded Adjustment: No 29.43 [1.20;722.58] C
excluded (control group) 		0/2   3,014/269,151 3,014 2
ref
S5914
R14942		 Artama (Phenytoin) (Controls unexposed, sick), 2013 5-min Apgar <7 3rd trimester population based cohort retrospective unexposed, sick Adjustment: No 61.76 [2.13;1793.52] C 0/2   3/652 3 2
ref
S6413
R17576		 Pennell (Phenytoin), 2012 Apgar score (at 5 minutes < 7) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick Adjustment: No 9.55 [0.45;202.85] C 2/53   0/97 2 53
ref
Total 2 studies 22.18 [2.31;213.27] 5 55
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 (Phenytoin) (Controls unexposed, sick), 2013Artama, 2013 1 61.76[2.13; 1793.52]3245%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Pennell (Phenytoin), 2012Pennell, 2012 2 9.55[0.45; 202.85]25355%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (2 studies) I2 = 0% 22.18[2.31; 213.27]5550.9500.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Phenytoin) (Controls unexposed, sick; 2: Phenytoin;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 22.18[2.31; 213.27]5550%NAArtama (Phenytoin) (Controls unexposed, sick), 2013 Pennell (Phenytoin), 2012 2 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 61.76[2.13; 1793.52]32 -NAArtama (Phenytoin) (Controls unexposed, sick), 2013 1 exposed to other treatment, sickexposed to other treatment, sick 9.55[0.45; 202.85]253 -NAPennell (Phenytoin), 2012 1 Tags Adjustment   - No  - No 22.18[2.31; 213.27]5550%NAArtama (Phenytoin) (Controls unexposed, sick), 2013 Pennell (Phenytoin), 2012 2 All studiesAll studies 22.18[2.31; 213.27]5550%NAArtama (Phenytoin) (Controls unexposed, sick), 2013 Pennell (Phenytoin), 2012 20.51000.01.0

Publication bias and p-hacking diagnosis

funnel plot

Funnel plot not drawn. Less than 3 points.

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

not enought points

p values plot

Funnel plot not drawn. Less than 3 points.

Sub-groups analysis using all included studies

excluded 5922, 305

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) Out of scale29.43[1.20; 722.58]3,0142 -NAArtama (Phenytoin) (Controls unexposed, disease free), 2013 1 unexposed, sick controlsunexposed, sick controls Out of scale61.76[2.13; 1793.52]32 -NAArtama (Phenytoin) (Controls unexposed, sick), 2013 1 exposed to other treatment, sick controlsexposed to other treatment, sick controls Out of scale10.68[1.11; 102.81]5550%NAArtama (Phenytoin) (Controls exposed to Lamotrigine, sick), 2013 Pennell (Phenytoin), 2012 20.510.01.0