Lamotrigine (Epilepsy)

ASD (Autism spectrum disorder): Diagnosis/Risk

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.
S15870
R65394		 Dreier, 2023 Autism spectrum disorder - 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 0.86 [0.65;1.14] 64/5,288   323/22,203 387 5,288
ref
S8022
R39730		 Wiggs, 2020 Austism Spectrum Disorder (after 2 years of age) at least 1st trimester population based cohort retrospective unexposed, sick Adjustment: Yes 0.66 [0.27;1.58] -/-   -/11,298 - -
ref
S9930
R39724		 Bjørk (Controls unexposed, disease free), 2018 Autistic traits at 18 months and/or at 36 months (M-CHAT <2/6 critical or <3/23 or SCQ >13) during pregnancy (anytime or not specified) population based cohort propective unexposed, disease free excluded Adjustment: No 2.05 [1.13;3.72] C
excluded (control group) 		13/76   6,907/75,497 6,920 76
ref
S9974
R39725		 Bjørk (Controls unexposed, sick), 2018 Autistic traits at 18 months and/or at 36 months (M-CHAT <2/6 critical or <3/23 or SCQ >13) during pregnancy (anytime or not specified) population based cohort propective unexposed, sick Adjustment: No 1.87 [0.91;3.84] C 13/76   27/272 40 76
ref
S7964
R39753		 Cohen-Israel, 2018 Autism (a majority between 6-12 years old) 1st trimester retrospective cohort unexposed, disease free Adjustment: No Matched 0.33 [0.01;8.20] C 0/83   1/83 1 83
ref
S6604
R39735		 Bromley (Controls unexposed, disease free), 2013 Autistic Spectrum Disorders (at 6 years old) during pregnancy (anytime or not specified) prospective cohort unexposed, disease free excluded Adjustment: No 1.81 [0.20;16.76] C
excluded (control group) 		1/30   4/214 5 30
ref
S6603
R39737		 Bromley (Controls unexposed, sick), 2013 Autistic Spectrum Disorders (at 6 years old) during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No 2.68 [0.10;68.88] C 1/30   0/26 1 30
ref
Total 5 studies 0.99 [0.65;1.50] 429 5,477
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, 2023Dreier, 2023 0.86[0.65; 1.14]3875,28856%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Wiggs, 2020Wiggs, 2020 0.66[0.27; 1.58]--17%ROB confusion: seriousROB selection: lowROB classification: lowROB missing: moderateROB mesure: moderateROB reporting: moderate Bjørk (Controls unexposed, sick), 2018Bjørk, 2018 1 1.87[0.91; 3.84]407623%ROB confusion: unclearROB selection: lowROB classification: lowROB missing: lowROB mesure: moderateROB reporting: moderate Cohen-Israel, 2018Cohen-Israel, 2018 0.33[0.01; 8.20]1832%ROB confusion: criticalROB selection: criticalROB classification: criticalROB missing: unclearROB mesure: criticalROB reporting: moderate Bromley (Controls unexposed, sick), 2013Bromley, 2013 2 2.68[0.10; 68.88]1302%ROB confusion: criticalROB selection: lowROB classification: lowROB missing: moderateROB mesure: moderateROB reporting: moderate Total (5 studies) I2 = 25% 0.99[0.65; 1.50]4295,4770.210.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, sick; 2: Controls unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 0.99[0.65; 1.50]4295,47725%NADreier, 2023 Wiggs, 2020 Bjørk (Controls unexposed, sick), 2018 Cohen-Israel, 2018 Bromley (Controls unexposed, sick), 2013 5 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 0.33[0.01; 8.20]183 -NACohen-Israel, 2018 1 unexposed, sickunexposed, sick 1.02[0.64; 1.64]4285,39439%NADreier, 2023 Wiggs, 2020 Bjørk (Controls unexposed, sick), 2018 Bromley (Controls unexposed, sick), 2013 4 Tags Adjustment   - No  - No 1.76[0.89; 3.49]421890%NABjørk (Controls unexposed, sick), 2018 Cohen-Israel, 2018 Bromley (Controls unexposed, sick), 2013 3   - Yes  - Yes 0.84[0.64; 1.10]3875,2880%NADreier, 2023 Wiggs, 2020 2 MatchedMatched 0.33[0.01; 8.20]183 -NACohen-Israel, 2018 1 All studiesAll studies 0.99[0.65; 1.50]4295,47725%NADreier, 2023 Wiggs, 2020 Bjørk (Controls unexposed, sick), 2018 Cohen-Israel, 2018 Bromley (Controls unexposed, sick), 2013 50.110.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.93.91.9870.000Dreier, 2023Wiggs, 2020Bjørk (Controls unexposed, sick), 2018Cohen-Israel, 2018Bromley (Controls unexposed, sick), 2013

Asymetry test p-value = 0.7529 (by Egger's regression)

slope=-0.1416 (0.2507); intercept=0.3040 (0.8813); t=0.3449; p=0.7529

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 6604, 9930

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.92[1.09; 3.39]6,9261890%NABjørk (Controls unexposed, disease free), 2018 Cohen-Israel, 2018 Bromley (Controls unexposed, disease free), 2013 3 unexposed, sick controlsunexposed, sick controls 1.02[0.64; 1.64]4285,39439%NADreier, 2023 Wiggs, 2020 Bjørk (Controls unexposed, sick), 2018 Bromley (Controls unexposed, sick), 2013 40.510.01.0

Umbrella review (other published meta-analyses)

Published MATE95% CIn exposedkI2Control groupExposition period Veroniki (MA)Veroniki (MA) Out of scale13.77[2.06; 188.00]-whatever (meta-analysis)1st trimesterstudies2 Veroniki (NMA)Veroniki (NMA) Out of scale10.24[1.25; 171.40]-whatever (meta-analysis)during pregnancy (anytime or not specified)studies-9 metaPregmetaPreg 0.99[0.65; 1.50]25%5,477--Dreier, 2023 Wiggs, 2020 Bjørk (Controls unexposed, sick), 2018 Cohen-Israel, 2018 Bromley (Controls unexposed, sick), 2013 50.510.01.0