Topiramate (All indications) updated on 04-22-2025

Intrauterine deaths (as a whole or unspecified)

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.
S18760
R79786
Moore (Topiramate) (Mixed indications) (Controls exposed to LTG), 2025 Pregnancy loss (pregnancy outcome other than live birth at any gestation, including spontaneous loss (miscarriage, stillbirth) and termination of pregnancy) during pregnancy (anytime or not specified) population based cohort retrospective exposed to other treatment, sick excluded Adjustment: No 1.38 [1.08;1.75] C
excluded (control group)
120/391   481/1,976 601 391
ref
S18761
R79790
Moore (Topiramate) (Mixed indications) (Controls unexposed, general pop), 2025 Pregnancy loss (pregnancy outcome other than live birth at any gestation, including spontaneous loss (miscarriage, stillbirth) and termination of pregnancy) during pregnancy (anytime or not specified) population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes Matched 1.28 [1.01;1.63] 120/391   894/3,828 1,014 391
ref
S16756
R70384
Vajda (Topiramate) (Controls exposed to LTG) (Epilepsy), 2024 Intra uterine foetal death (including both spontaneous abortions and stillbirths, but not elective termination) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No 0.72 [0.09;5.75] C
excluded (control group)
1/45   10/326 11 45
ref
S16204
R67134
Vajda (Topiramate) (Controls unexposed sick) (Epilepsy), 2024 Intra uterine foetal death (including both spontaneous abortions and stillbirths, but not elective termination) during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No 10.24 [0.41;255.93] C 1/45   0/149 1 45
ref
S8564
R28485
Meador (Topiramate) (Controls exposed to Lamotrigine, sick), 2020 Fetal loss (Spontaneous miscarriages and fetal death) 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No 2.84 [0.13;62.17] C
excluded (control group)
0/6   3/113 3 6
ref
S8565
R28489
Meador (Topiramate) (Controls unexposed, disease free), 2020 Fetal loss (Spontaneous miscarriages and fetal death) 1st trimester prospective cohort unexposed, disease free excluded Adjustment: No 19.18 [0.35;1060.61] C
excluded (control group)
0/6   0/106 0 6
ref
S8566
R28493
Meador (Topiramate) (Controls unexposed, sick), 2020 Fetal loss (Spontaneous miscarriages and fetal death) 1st trimester prospective cohort unexposed, sick Adjustment: No 2.64 [0.05;149.97] C 0/6   0/15 0 6
ref
S8578
R28537
Trivedi (Topiramate) (Controls exposed to Lamotrigine, sick), 2018 Spontaneous fetal loss (both spontaneous abortion before 20 weeks of gestation and stillbirths occurring after 20 weeks of gestation) 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No 9.17 [1.91;43.94] C
excluded (control group)
5/11   4/48 9 11
ref
S8579
R28538
Trivedi (Topiramate) (Controls unexposed, sick), 2018 Spontaneous fetal loss (both spontaneous abortion before 20 weeks of gestation and stillbirths occurring after 20 weeks of gestation) 1st trimester prospective cohort unexposed, sick Adjustment: Yes 38.86 [5.02;301.19] 5/11   5/178 10 11
ref
S8554
R28460
Arkilo (Topiramate), 2015 Unsuccessful pregnancies (miscarriages/stillbirths) during pregnancy (anytime or not specified) retrospective cohort exposed to other treatment, sick Adjustment: No 2.87 [0.09;91.05] C 0/2   2/24 2 2
ref
Total 5 studies 4.84 [0.85;27.69] 1,027 455
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 Moore (Topiramate) (Mixed indications) (Controls unexposed, general pop), 2025Moore, 2025 1 1.28[1.01; 1.63]1,01439134%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: low Vajda (Topiramate) (Controls unexposed sick) (Epilepsy), 2024Vajda, 2024 2 10.24[0.41; 255.93]14516%ROB confusion: criticalROB selection: criticalROB classification: unclearROB missing: unclearROB mesure: criticalROB reporting: moderate Meador (Topiramate) (Controls unexposed, sick), 2020Meador, 2020 3 2.64[0.05; 149.97]0612%ROB confusion: unclearROB selection: lowROB classification: lowROB missing: lowROB mesure: moderateROB reporting: low Trivedi (Topiramate) (Controls unexposed, sick), 2018Trivedi, 2018 4 38.86[5.02; 301.19]101123%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Arkilo (Topiramate), 2015Arkilo, 2015 5 2.87[0.09; 91.05]2215%ROB confusion: criticalROB selection: criticalROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Total (5 studies) I2 = 68% 4.84[0.85; 27.69]1,0274550.5100.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Topiramate) (Mixed indications) (Controls unexposed, general pop; 2: Topiramate) (Controls unexposed sick) (Epilepsy; 3: Topiramate) (Controls unexposed, sick; 4: Topiramate) (Controls unexposed, sick; 5: Topiramate;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 4.84[0.85; 27.69]1,02745568%NAMoore (Topiramate) (Mixed indications) (Controls unexposed, general pop), 2025 Vajda (Topiramate) (Controls unexposed sick) (Epilepsy), 2024 Meador (Topiramate) (Controls unexposed, sick), 2020 Trivedi (Topiramate) (Controls unexposed, sick), 2018 Arkilo (Topiramate), 2015 5 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.28[1.01; 1.63]1,014391 -NAMoore (Topiramate) (Mixed indications) (Controls unexposed, general pop), 2025 1 unexposed, sickunexposed, sick 18.53[3.79; 90.73]11620%NAVajda (Topiramate) (Controls unexposed sick) (Epilepsy), 2024 Meador (Topiramate) (Controls unexposed, sick), 2020 Trivedi (Topiramate) (Controls unexposed, sick), 2018 3 exposed to other treatment, sickexposed to other treatment, sick 2.87[0.09; 91.05]22 -NAArkilo (Topiramate), 2015 1 Tags Adjustment   - No  - No 4.67[0.61; 35.75]3530%NAVajda (Topiramate) (Controls unexposed sick) (Epilepsy), 2024 Meador (Topiramate) (Controls unexposed, sick), 2020 Arkilo (Topiramate), 2015 3   - Yes  - Yes 6.02[0.22; 168.40]1,02440291%NAMoore (Topiramate) (Mixed indications) (Controls unexposed, general pop), 2025 Trivedi (Topiramate) (Controls unexposed, sick), 2018 2 MatchedMatched 1.28[1.01; 1.63]1,014391 -NAMoore (Topiramate) (Mixed indications) (Controls unexposed, general pop), 2025 1 All studiesAll studies 4.84[0.85; 27.69]1,02745568%NAMoore (Topiramate) (Mixed indications) (Controls unexposed, general pop), 2025 Vajda (Topiramate) (Controls unexposed sick) (Epilepsy), 2024 Meador (Topiramate) (Controls unexposed, sick), 2020 Trivedi (Topiramate) (Controls unexposed, sick), 2018 Arkilo (Topiramate), 2015 50.5100.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-4.86.42.4740.000Moore (Topiramate) (Mixed indications) (Controls unexposed, general pop), 2025Vajda (Topiramate) (Controls unexposed sick) (Epilepsy), 2024Meador (Topiramate) (Controls unexposed, sick), 2020Trivedi (Topiramate) (Controls unexposed, sick), 2018Arkilo (Topiramate), 2015

Asymetry test p-value = 0.1614 (by Egger's regression)

slope=0.0884 (0.2054); intercept=1.4108 (0.7624); t=1.8504; p=0.1614

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 8578, 8564, 8565, 16756, 18760

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 2.29[0.26; 20.27]1,01439743%NAMoore (Topiramate) (Mixed indications) (Controls unexposed, general pop), 2025 Meador (Topiramate) (Controls unexposed, disease free), 2020 2 unexposed, sick controlsunexposed, sick controls Out of scale18.53[3.79; 90.73]11620%NAVajda (Topiramate) (Controls unexposed sick) (Epilepsy), 2024 Meador (Topiramate) (Controls unexposed, sick), 2020 Trivedi (Topiramate) (Controls unexposed, sick), 2018 3 exposed to other treatment, sick controlsexposed to other treatment, sick controls 2.03[0.84; 4.92]62645536%NAMoore (Topiramate) (Mixed indications) (Controls exposed to LTG), 2025 Vajda (Topiramate) (Controls exposed to LTG) (Epilepsy), 2024 Meador (Topiramate) (Controls exposed to Lamotrigine, sick), 2020 Trivedi (Topiramate) (Controls exposed to Lamotrigine, sick), 2018 Arkilo (Topiramate), 2015 50.510.01.0

Umbrella review (other published meta-analyses)

Published MAControlPeriodTE95% CIn exposedkI2 Veroniki a (NMA) (All indications) (Combined ...Veroniki a (NMA) (All indications) (Combined fetal losses) Out of scale23.58[1.18; 549.60]NA-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT-9 metaPregmetaPreg 4.84[0.85; 27.69]68%455----Moore (Topiramate) (Mixed indications) (Controls unexposed, general pop), 2025 Vajda (Topiramate) (Controls unexposed sick) (Epilepsy), 2024 Meador (Topiramate) (Controls unexposed, sick), 2020 Trivedi (Topiramate) (Controls unexposed, sick), 2018 Arkilo (Topiramate), 2015 50.510.01.0