Lamotrigine (Epilepsy) updated on 04-22-2025

Limb 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
R82775		 Seo (Epilepsy), 2026 Limb defects 1st trimester population based cohort retrospective unexposed, sick Adjustment: Yes 2.17 [0.83;5.66] -/-   -/- - -
ref
S17506
R73588		 Wiggs, 2024 Musculoskeletal system malformations early pregnancy population based cohort retrospective unexposed, sick Adjustment: Yes 1.05 [0.72;1.52] -/1,412   -/9,364 - 1,412
ref
S7514
R47136		 Thomas (Controls unexposed, sick), 2021 Skeletal malformations 1st trimester prospective cohort unexposed, sick Adjustment: No 1.36 [0.06;28.82] C 0/50   2/340 2 50
ref
S9826
R37686		 Vajda, 2013 Skeletal / Limb Malformations at least 1st trimester prospective cohort unexposed, sick Adjustment: No 0.15 [0.01;3.81] C 0/315   1/147 1 315
ref
S9843
R35299		 Mawer (Controls unexposed, disease free), 2010 Skeletal / Limb Malformations 1st trimester prospective cohort unexposed, disease free excluded Adjustment: No Matched 24.04 [0.96;601.51] C
excluded (control group) 		1/37   0/285 1 37
ref
S9844
R35305		 Mawer (Controls unexposed, sick), 2010 Skeletal / Limb Malformations 1st trimester prospective cohort unexposed, sick Adjustment: No 3.42 [0.14;86.71] C 1/37   0/41 1 37
ref
Total 5 studies 1.15 [0.81;1.61] 4 1,814
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 2.17[0.83; 5.66]--13%ROB confusion: seriousROB selection: moderateROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Wiggs, 2024Wiggs, 2024 1.05[0.72; 1.52]-1,41284%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Thomas (Controls unexposed, sick), 2021Thomas, 2021 2 1.36[0.06; 28.82]2501%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Vajda, 2013Vajda, 2013 0.15[0.01; 3.81]13151%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Mawer (Controls unexposed, sick), 2010Mawer, 2010 3 3.42[0.14; 86.71]1371%ROB confusion: criticalROB selection: moderateROB classification: lowROB missing: moderateROB mesure: moderateROB reporting: moderate Total (5 studies) I2 = 0% 1.15[0.81; 1.61]41,8140.010.01.0ROB: 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 1.15[0.81; 1.61]41,8140%NASeo (Epilepsy), 2026 Wiggs, 2024 Thomas (Controls unexposed, sick), 2021 Vajda, 2013 Mawer (Controls unexposed, sick), 2010 5 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 1.15[0.81; 1.61]41,8140%NASeo (Epilepsy), 2026 Wiggs, 2024 Thomas (Controls unexposed, sick), 2021 Vajda, 2013 Mawer (Controls unexposed, sick), 2010 5 Tags Adjustment   - No  - No 0.90[0.15; 5.60]44020%NAThomas (Controls unexposed, sick), 2021 Vajda, 2013 Mawer (Controls unexposed, sick), 2010 3   - Yes  - Yes 1.31[0.68; 2.53]-1,41248%NASeo (Epilepsy), 2026 Wiggs, 2024 2 All studiesAll studies 1.15[0.81; 1.61]41,8140%NASeo (Epilepsy), 2026 Wiggs, 2024 Thomas (Controls unexposed, sick), 2021 Vajda, 2013 Mawer (Controls unexposed, sick), 2010 50.010.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.94.01.9790.000Seo (Epilepsy), 2026Wiggs, 2024Thomas (Controls unexposed, sick), 2021Vajda, 2013Mawer (Controls unexposed, sick), 2010

Asymetry test p-value = 0.8351 (by Egger's regression)

slope=0.0902 (0.2804); intercept=0.1630 (0.7188); t=0.2268; p=0.8351

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) Out of scale24.04[0.96; 601.51]137 -NAMawer (Controls unexposed, disease free), 2010 1 unexposed, sick controlsunexposed, sick controls 1.15[0.81; 1.61]41,8140%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 Weston (Skeletal / Limb Malformations)Weston (Skeletal / Limb Malformations) 0.72[0.12; 4.12]40-U,Sunexposed, sickAnyduring pregnancy (anytime or not specified)studies TTT2 Weston (Skeletal / Limb Malformations)Weston (Skeletal / Limb Malformations) Out of scale23.12[0.96; 558.25]NA-U,DFunexposed, disease freeAnyduring pregnancy (anytime or not specified)studies TTT1 metaPregmetaPreg 1.15[0.81; 1.61]0%1,814----Seo (Epilepsy), 2026 Wiggs, 2024 Thomas (Controls unexposed, sick), 2021 Vajda, 2013 Mawer (Controls unexposed, sick), 2010 50.510.01.0