Phenytoin (Epilepsy)

Small for gestational age (weight)

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.
S8086
R24721		 Aydin (Phenytoin) (Controls exposed to Lamotrigine, sick), 2020 Small for gestational age (birth weight) throughout pregnancy retrospective cohort exposed to other treatment, sick excluded Adjustment: No 13.00 [0.10;1680.94] C
excluded (control group) 		0/1   0/7 0 1
ref
S8079
R24660		 Aydin (Phenytoin) (Controls unexposed, sick), 2020 Small for gestational age (birth weight) throughout pregnancy retrospective cohort unexposed, sick Adjustment: No 43.00 [0.35;5328.22] C 0/1   0/22 0 1
ref
S5922
R15044		 Artama (Phenytoin) (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 1.34 [0.06;28.66] C
excluded (control group) 		0/26   2/173 2 26
ref
S305
R14836		 Artama (Phenytoin) (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: No 0.98 [0.06;16.14] C
excluded (control group) 		0/26   14,079/719,509 14,079 26
ref
S5914
R14948		 Artama (Phenytoin) (Controls unexposed, sick), 2013 Small for gestational age (weight) during pregnancy (anytime or not specified) population based cohort retrospective unexposed, sick Adjustment: No 0.81 [0.05;13.49] C 0/26   42/1,793 42 26
ref
S6413
R17570		 Pennell (Phenytoin), 2012 Small for gestational age (SGA) (at birth) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick Adjustment: Yes 0.56 [0.09;3.46] 2/55   4/98 6 55
ref
S6303
R17072		 Wide (Phenytoin), 2000 Small for gestationnal age throughout pregnancy prospective cohort unexposed (general population or NOS) Adjustment: No Matched 0.86 [0.02;45.54] C 0/22   0/19 0 22
ref
Total 4 studies 0.91 [0.23;3.59] 48 104
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 Aydin (Phenytoin) (Controls unexposed, sick), 2020Aydin, 2020 1 43.00[0.35; 5328.22]018%ROB confusion: criticalROB selection: criticalROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Artama (Phenytoin) (Controls unexposed, sick), 2013Artama, 2013 2 0.81[0.05; 13.49]422624%ROB confusion: moderateROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Pennell (Phenytoin), 2012Pennell, 2012 3 0.56[0.09; 3.46]65556%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Wide (Phenytoin), 2000Wide, 2000 4 0.86[0.02; 45.54]02212%ROB confusion: criticalROB selection: lowROB classification: lowROB missing: lowROB mesure: moderateROB reporting: moderate Total (4 studies) I2 = 0% 0.91[0.23; 3.59]481040.2100.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

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

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 0.91[0.23; 3.59]481040%NAAydin (Phenytoin) (Controls unexposed, sick), 2020 Artama (Phenytoin) (Controls unexposed, sick), 2013 Pennell (Phenytoin), 2012 Wide (Phenytoin), 2000 4 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 0.86[0.02; 45.54]-22 -NAWide (Phenytoin), 2000 1 unexposed, sickunexposed, sick 3.57[0.08; 154.82]422749%NAAydin (Phenytoin) (Controls unexposed, sick), 2020 Artama (Phenytoin) (Controls unexposed, sick), 2013 2 exposed to other treatment, sickexposed to other treatment, sick 0.56[0.09; 3.47]655 -NAPennell (Phenytoin), 2012 1 Tags Adjustment   - No  - No 1.76[0.21; 15.07]42495%NAAydin (Phenytoin) (Controls unexposed, sick), 2020 Artama (Phenytoin) (Controls unexposed, sick), 2013 Wide (Phenytoin), 2000 3   - Yes  - Yes 0.56[0.09; 3.47]655 -NAPennell (Phenytoin), 2012 1 MatchedMatched 0.86[0.02; 45.54]-22 -NAWide (Phenytoin), 2000 1 All studiesAll studies 0.91[0.23; 3.59]481040%NAAydin (Phenytoin) (Controls unexposed, sick), 2020 Artama (Phenytoin) (Controls unexposed, sick), 2013 Pennell (Phenytoin), 2012 Wide (Phenytoin), 2000 40.2100.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-5.85.72.9510.000Aydin (Phenytoin) (Controls unexposed, sick), 2020Artama (Phenytoin) (Controls unexposed, sick), 2013Pennell (Phenytoin), 2012Wide (Phenytoin), 2000

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 5922, 305, 8086

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 0.94[0.10; 9.26]14,079480%NAArtama (Phenytoin) (Controls unexposed, disease free), 2013 Wide (Phenytoin), 2000 2 unexposed, sick controlsunexposed, sick controls 3.57[0.08; 154.82]422749%NAAydin (Phenytoin) (Controls unexposed, sick), 2020 Artama (Phenytoin) (Controls unexposed, sick), 2013 2 exposed to other treatment, sick controlsexposed to other treatment, sick controls 0.93[0.21; 4.12]8820%NAAydin (Phenytoin) (Controls exposed to Lamotrigine, sick), 2020 Artama (Phenytoin) (Controls exposed to Lamotrigine, sick), 2013 Pennell (Phenytoin), 2012 30.510.01.0