Lamotrigine (Epilepsy)

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.
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 4 studies 1.64 [0.62;4.32] 26 516
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 Thomas (Controls unexposed, sick), 2021Thomas, 2021 1 0.75[0.09; 6.05]105022%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Diav-Citrin, 2017Diav-Citrin, 2017 2.46[0.66; 9.22]1211454%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Vajda, 2013Vajda, 2013 1.40[0.14; 13.61]431518%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Mawer (Controls unexposed, sick), 2010Mawer, 2010 2 1.11[0.02; 57.36]0376%ROB confusion: criticalROB selection: moderateROB classification: lowROB missing: moderateROB mesure: moderateROB reporting: moderate Total (4 studies) I2 = 0% 1.64[0.62; 4.32]265160.25.01.0ROB: 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 1.64[0.62; 4.32]265160%NAThomas (Controls unexposed, sick), 2021 Diav-Citrin, 2017 Vajda, 2013 Mawer (Controls unexposed, sick), 2010 4 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 1.01[0.24; 4.25]144020%NAThomas (Controls unexposed, sick), 2021 Vajda, 2013 Mawer (Controls unexposed, sick), 2010 3 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 All studiesAll studies 1.64[0.62; 4.32]265160%NAThomas (Controls unexposed, sick), 2021 Diav-Citrin, 2017 Vajda, 2013 Mawer (Controls unexposed, sick), 2010 40.25.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-4.75.22.4160.000Thomas (Controls unexposed, sick), 2021Diav-Citrin, 2017Vajda, 2013Mawer (Controls unexposed, sick), 2010

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 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 1.01[0.24; 4.25]144020%NAThomas (Controls unexposed, sick), 2021 Vajda, 2013 Mawer (Controls unexposed, sick), 2010 30.510.01.0

Umbrella review (other published meta-analyses)

Published MATE95% CIn exposedkI2Control groupExposition period Veroniki (MA)Veroniki (MA) 1.73[0.05; 21.66]-whatever (meta-analysis)1st trimesterstudies-9 Veroniki (NMA)Veroniki (NMA) 0.55[0.32; 0.95]0-whatever (meta-analysis)during pregnancy (anytime or not specified)studies12 WestonWeston 2.57[0.11; 62.03]NA-unexposed, disease freeduring pregnancy (anytime or not specified)studies1 WestonWeston 1.40[0.15; 13.35]0-unexposed, sickduring pregnancy (anytime or not specified)studies2 metaPregmetaPreg 1.64[0.62; 4.32]0%516--Thomas (Controls unexposed, sick), 2021 Diav-Citrin, 2017 Vajda, 2013 Mawer (Controls unexposed, sick), 2010 40.510.01.0