Lamotrigine (Epilepsy) updated on 04-22-2025

Congenital heart defects

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.
S19428
R82774		 Seo (Epilepsy), 2026 Congenital Heart Defects 1st trimester population based cohort retrospective unexposed, sick Adjustment: Yes 1.10 [0.61;1.99] -/-   -/- - -
ref
S17506
R73582		 Wiggs, 2024 Circulatory system malformations early pregnancy population based cohort retrospective unexposed, sick Adjustment: Yes 0.94 [0.64;1.38] -/1,412   -/9,364 - 1,412
ref
S7514
R47133		 Thomas (Controls unexposed, sick), 2021 Cardiac malformations 1st trimester prospective cohort unexposed, sick Adjustment: No 0.75 [0.09;6.05] C 1/50   9/340 10 50
ref
S7719
R35919		 Diav-Citrin, 2017 Cardiovascular anomalies without chromosomal anomalies at least 1st trimester prospective cohort unexposed, disease free Adjustment: No 2.46 [0.66;9.22] C 3/114   9/828 12 114
ref
S9826
R37684		 Vajda, 2013 Cardiac Malformations at least 1st trimester prospective cohort unexposed, sick Adjustment: No 1.40 [0.14;13.61] C 3/315   1/147 4 315
ref
S9843
R35297		 Mawer (Controls unexposed, disease free), 2010 Cardiac Malformations 1st trimester prospective cohort unexposed, disease free excluded Adjustment: No Matched 2.59 [0.10;64.75] C
excluded (control group) 		0/37   1/285 1 37
ref
S9844
R35303		 Mawer (Controls unexposed, sick), 2010 Cardiac Malformations 1st trimester prospective cohort unexposed, sick Adjustment: No 1.11 [0.02;57.36] C 0/37   0/41 0 37
ref
Total 6 studies 1.04 [0.76;1.41] 26 1,928
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 Seo (Epilepsy), 2026Seo, 2026 1 1.10[0.61; 1.99]--27%ROB confusion: seriousROB selection: moderateROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Wiggs, 2024Wiggs, 2024 0.94[0.64; 1.38]-1,41263%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Thomas (Controls unexposed, sick), 2021Thomas, 2021 2 0.75[0.09; 6.05]10502%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Diav-Citrin, 2017Diav-Citrin, 2017 2.46[0.66; 9.22]121145%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Vajda, 2013Vajda, 2013 1.40[0.14; 13.61]43152%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Mawer (Controls unexposed, sick), 2010Mawer, 2010 3 1.11[0.02; 57.36]0371%ROB confusion: criticalROB selection: moderateROB classification: lowROB missing: moderateROB mesure: moderateROB reporting: moderate Total (6 studies) I2 = 0% 1.04[0.76; 1.41]261,9280.25.01.0ROB: A: confounding, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Epilepsy; 2: Controls unexposed, sick; 3: Controls unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.04[0.76; 1.41]261,9280%NASeo (Epilepsy), 2026 Wiggs, 2024 Thomas (Controls unexposed, sick), 2021 Diav-Citrin, 2017 Vajda, 2013 Mawer (Controls unexposed, sick), 2010 6 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 2.46[0.66; 9.22]12114 -NADiav-Citrin, 2017 1 unexposed, sickunexposed, sick 0.99[0.72; 1.35]141,8140%NASeo (Epilepsy), 2026 Wiggs, 2024 Thomas (Controls unexposed, sick), 2021 Vajda, 2013 Mawer (Controls unexposed, sick), 2010 5 Tags Adjustment   - No  - No 1.64[0.62; 4.32]265160%NAThomas (Controls unexposed, sick), 2021 Diav-Citrin, 2017 Vajda, 2013 Mawer (Controls unexposed, sick), 2010 4   - Yes  - Yes 0.98[0.71; 1.36]-1,4120%NASeo (Epilepsy), 2026 Wiggs, 2024 2 All studiesAll studies 1.04[0.76; 1.41]261,9280%NASeo (Epilepsy), 2026 Wiggs, 2024 Thomas (Controls unexposed, sick), 2021 Diav-Citrin, 2017 Vajda, 2013 Mawer (Controls unexposed, sick), 2010 60.25.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-4.74.82.4160.000Seo (Epilepsy), 2026Wiggs, 2024Thomas (Controls unexposed, sick), 2021Diav-Citrin, 2017Vajda, 2013Mawer (Controls unexposed, sick), 2010

Asymetry test p-value = 0.3823 (by Egger's regression)

slope=-0.0875 (0.1608); intercept=0.4128 (0.4209); t=0.9807; p=0.3823

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 9843

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 2.48[0.73; 8.41]131510%NADiav-Citrin, 2017 Mawer (Controls unexposed, disease free), 2010 2 unexposed, sick controlsunexposed, sick controls 0.99[0.72; 1.35]141,8140%NASeo (Epilepsy), 2026 Wiggs, 2024 Thomas (Controls unexposed, sick), 2021 Vajda, 2013 Mawer (Controls unexposed, sick), 2010 50.510.01.0

Umbrella review (other published meta-analyses)

Published MAControlPeriodTE95% CIn exposedkI2 Veroniki (MA) (Cardiac Malformations)Veroniki (MA) (Cardiac Malformations) 1.73[0.05; 21.66]-Wwhatever (meta-analysis)T11st trimesterstudies TTT-9 Veroniki (NMA) (Cardiac malformations)Veroniki (NMA) (Cardiac malformations) 0.55[0.32; 0.95]0-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT12 Weston (Cardiac Malformations)Weston (Cardiac Malformations) 2.57[0.11; 62.03]NA-U,DFunexposed, disease freeAnyduring pregnancy (anytime or not specified)studies TTT1 Weston (Cardiac Malformations)Weston (Cardiac Malformations) 1.40[0.15; 13.35]0-U,Sunexposed, sickAnyduring pregnancy (anytime or not specified)studies TTT2 metaPregmetaPreg 1.04[0.76; 1.41]0%1,928----Seo (Epilepsy), 2026 Wiggs, 2024 Thomas (Controls unexposed, sick), 2021 Diav-Citrin, 2017 Vajda, 2013 Mawer (Controls unexposed, sick), 2010 60.510.01.0