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

Small for gestational age (weight)

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.
S16185
R79422		 The NAAED (Levetiracetam) (Controls exposed to LTG) (Indications NOS), 2025 Small for gestational age at least 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No 1.24 [0.97;1.58] C
excluded (control group) 		113/1,283   178/2,461 291 1,283
ref
S16175
R79438		 The NAAED (Levetiracetam) (Controls unexposed, disease free) (Indications NOS), 2025 Small for gestational age at least 1st trimester prospective cohort unexposed, disease free Adjustment: No 0.92 [0.71;1.21] C 113/1,283   124/1,311 237 1,283
ref
S16071
R66694		 Christensen (Levetiracetam) (All indications) (Controls exposed to LTG), 2024 Small for gestational age (a z-score for birth weight ≤10th percentile for gestational week, sex, and country (including newborns with congenital malformations)) during pregnancy (anytime or not specified) population based cohort retrospective exposed to other treatment, sick excluded Adjustment: No 1.12 [0.92;1.36] C
excluded (control group) 		125/1,077   920/8,756 1,045 1,077
ref
S16037
R66567		 Christensen (Levetiracetam) (All indications) (Controls unexposed, general population), 2024 Small for gestational age (a z-score for birth weight ≤10th percentile for gestational week, sex, and country (including newborns with congenital malformations)) during pregnancy (anytime or not specified) population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes 1.08 [0.89;1.32] 125/1,077   446,267/4,467,848 446,392 1,077
ref
S15220
R62419		 Bromley (Levetiracetam) (Epilepsy) (Controls exposed to LTG), 2023 Small for gestation (calculated using gender-specific scales) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No 0.67 [0.24;1.86] C
excluded (control group) 		6/70   13/106 19 70
ref
S15219
R62406		 Bromley (Levetiracetam) (Epilepsy) (Controls unexposed, sick), 2023 Small for gestation (calculated using gender-specific scales) during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No 0.48 [0.17;1.35] C 6/70   13/80 19 70
ref
S12618
R47566		 Van Marter (Levetiracetam) (Controls unexposed, disease free), 2021 Small for gestational age (weight for gestational age <10th percentile) at least 1st trimester prospective cohort unexposed, disease free excluded Adjustment: No 0.75 [0.26;2.19] C
excluded (control group) 		6/89   9/102 15 89
ref
S12615
R47548		 Van Marter (Levetiracetam) (Controls unexposed, sick), 2021 Small for gestational age (weight for gestational age <10th percentile) at least 1st trimester prospective cohort unexposed, sick Adjustment: No 2.13 [0.11;39.98] C 6/89   0/14 6 89
ref
S8986
R30513		 Aydin (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2020 Small for gestational age (birth weight) throughout pregnancy retrospective cohort exposed to other treatment, sick excluded Adjustment: No 7.00 [0.30;164.40] C
excluded (control group) 		3/10   0/7 3 10
ref
S8987
R30523		 Aydin (Levetiracetam) (Controls unexposed, sick), 2020 Small for gestational age (birth weight) throughout pregnancy retrospective cohort unexposed, sick Adjustment: No 23.15 [1.05;509.05] C 3/10   0/22 3 10
ref
S9020
R30711		 Coste (Levetiracetam) (Controls unexposed, NOS), 2020 Small for gestational age (weight) during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No 1.40 [1.11;1.77] C 82/621   167,376/1,710,441 167,458 621
ref
S9029
R30780		 Bank (Levetiracetam) (Mixed indications), 2017 Small for Gestational Age birthweight (<10th percentile) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick Adjustment: No 1.83 [0.16;20.71] C 1/7   3/36 4 7
ref
Total 7 studies 1.11 [0.86;1.43] 614,119 3,157
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 The NAAED (Levetiracetam) (Controls unexposed, disease free) (Indications NOS), 2025The NAAED, 2025 1 0.92[0.71; 1.21]2371,28328%ROB confusion: criticalROB selection: unclearROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: low Christensen (Levetiracetam) (All indications) (Controls unexposed, general population), 2024Christensen, 2024 2 1.08[0.89; 1.32]446,3921,07733%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Bromley (Levetiracetam) (Epilepsy) (Controls unexposed, sick), 2023Bromley, 2023 3 0.48[0.17; 1.35]19705%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: moderateROB mesure: moderateROB reporting: low Van Marter (Levetiracetam) (Controls unexposed, sick), 2021Van Marter, 2021 4 2.13[0.11; 39.98]6891%ROB confusion: criticalROB selection: lowROB classification: lowROB missing: lowROB mesure: moderateROB reporting: low Aydin (Levetiracetam) (Controls unexposed, sick), 2020Aydin, 2020 5 23.15[1.05; 509.05]3101%ROB confusion: criticalROB selection: criticalROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Coste (Levetiracetam) (Controls unexposed, NOS), 2020Coste, 2020 6 1.40[1.11; 1.77]167,45862131%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Bank (Levetiracetam) (Mixed indications), 2017Bank, 2017 7 1.83[0.16; 20.71]471%ROB confusion: criticalROB selection: lowROB classification: lowROB missing: lowROB mesure: moderateROB reporting: moderate Total (7 studies) I2 = 51% 1.11[0.86; 1.43]614,1193,1570.250.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Levetiracetam) (Controls unexposed, disease free) (Indications NOS; 2: Levetiracetam) (All indications) (Controls unexposed, general population; 3: Levetiracetam) (Epilepsy) (Controls unexposed, sick; 4: Levetiracetam) (Controls unexposed, sick; 5: Levetiracetam) (Controls unexposed, sick; 6: Levetiracetam) (Controls unexposed, NOS; 7: Levetiracetam) (Mixed indications;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.11[0.86; 1.43]614,1193,15751%NAThe NAAED (Levetiracetam) (Controls unexposed, disease free) (Indications NOS), 2025 Christensen (Levetiracetam) (All indications) (Controls unexposed, general population), 2024 Bromley (Levetiracetam) (Epilepsy) (Controls unexposed, sick), 2023 Van Marter (Levetiracetam) (Controls unexposed, sick), 2021 Aydin (Levetiracetam) (Controls unexposed, sick), 2020 Coste (Levetiracetam) (Controls unexposed, NOS), 2020 Bank (Levetiracetam) (Mixed indications), 2017 7 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.12[0.90; 1.41]614,0872,98165%NAThe NAAED (Levetiracetam) (Controls unexposed, disease free) (Indications NOS), 2025 Christensen (Levetiracetam) (All indications) (Controls unexposed, general population), 2024 Coste (Levetiracetam) (Controls unexposed, NOS), 2020 3 unexposed, sickunexposed, sick 2.02[0.20; 19.85]2816966%NABromley (Levetiracetam) (Epilepsy) (Controls unexposed, sick), 2023 Van Marter (Levetiracetam) (Controls unexposed, sick), 2021 Aydin (Levetiracetam) (Controls unexposed, sick), 2020 3 exposed to other treatment, sickexposed to other treatment, sick 1.83[0.16; 20.71]47 -NABank (Levetiracetam) (Mixed indications), 2017 1 Tags Adjustment   - No  - No 1.11[0.73; 1.71]167,7272,08058%NAThe NAAED (Levetiracetam) (Controls unexposed, disease free) (Indications NOS), 2025 Bromley (Levetiracetam) (Epilepsy) (Controls unexposed, sick), 2023 Van Marter (Levetiracetam) (Controls unexposed, sick), 2021 Aydin (Levetiracetam) (Controls unexposed, sick), 2020 Coste (Levetiracetam) (Controls unexposed, NOS), 2020 Bank (Levetiracetam) (Mixed indications), 2017 6   - Yes  - Yes 1.08[0.89; 1.32]446,3921,077 -NAChristensen (Levetiracetam) (All indications) (Controls unexposed, general population), 2024 1 All studiesAll studies 1.11[0.86; 1.43]614,1193,15751%NAThe NAAED (Levetiracetam) (Controls unexposed, disease free) (Indications NOS), 2025 Christensen (Levetiracetam) (All indications) (Controls unexposed, general population), 2024 Bromley (Levetiracetam) (Epilepsy) (Controls unexposed, sick), 2023 Van Marter (Levetiracetam) (Controls unexposed, sick), 2021 Aydin (Levetiracetam) (Controls unexposed, sick), 2020 Coste (Levetiracetam) (Controls unexposed, NOS), 2020 Bank (Levetiracetam) (Mixed indications), 2017 70.250.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.83.81.8920.000The NAAED (Levetiracetam) (Controls unexposed, disease free) (Indications NOS), 2025Christensen (Levetiracetam) (All indications) (Controls unexposed, general population), 2024Bromley (Levetiracetam) (Epilepsy) (Controls unexposed, sick), 2023Van Marter (Levetiracetam) (Controls unexposed, sick), 2021Aydin (Levetiracetam) (Controls unexposed, sick), 2020Coste (Levetiracetam) (Controls unexposed, NOS), 2020Bank (Levetiracetam) (Mixed indications), 2017

Asymetry test p-value = 0.6887 (by Egger's regression)

slope=0.0691 (0.1522); intercept=0.3696 (0.8702); t=0.4248; p=0.6887

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 8986, 12618, 15220, 16071, 16185

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.11[0.90; 1.37]614,1023,07052%NAThe NAAED (Levetiracetam) (Controls unexposed, disease free) (Indications NOS), 2025 Christensen (Levetiracetam) (All indications) (Controls unexposed, general population), 2024 Van Marter (Levetiracetam) (Controls unexposed, disease free), 2021 Coste (Levetiracetam) (Controls unexposed, NOS), 2020 4 unexposed, sick controlsunexposed, sick controls 2.02[0.20; 19.85]2816966%NABromley (Levetiracetam) (Epilepsy) (Controls unexposed, sick), 2023 Van Marter (Levetiracetam) (Controls unexposed, sick), 2021 Aydin (Levetiracetam) (Controls unexposed, sick), 2020 3 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.16[0.99; 1.35]1,3622,4470%NAThe NAAED (Levetiracetam) (Controls exposed to LTG) (Indications NOS), 2025 Christensen (Levetiracetam) (All indications) (Controls exposed to LTG), 2024 Bromley (Levetiracetam) (Epilepsy) (Controls exposed to LTG), 2023 Aydin (Levetiracetam) (Controls exposed to Lamotrigine, sick), 2020 Bank (Levetiracetam) (Mixed indications), 2017 50.510.01.0

Umbrella review (other published meta-analyses)

Published MAControlPeriodTE95% CIn exposedkI2 Veroniki a (NMA) (All indications) (Prenatal ...Veroniki a (NMA) (All indications) (Prenatal growth restriction) 1.27[0.34; 3.54]NA-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT-9 metaPregmetaPreg 1.11[0.86; 1.43]51%3,157----The NAAED (Levetiracetam) (Controls unexposed, disease free) (Indications NOS), 2025 Christensen (Levetiracetam) (All indications) (Controls unexposed, general population), 2024 Bromley (Levetiracetam) (Epilepsy) (Controls unexposed, sick), 2023 Van Marter (Levetiracetam) (Controls unexposed, sick), 2021 Aydin (Levetiracetam) (Controls unexposed, sick), 2020 Coste (Levetiracetam) (Controls unexposed, NOS), 2020 Bank (Levetiracetam) (Mixed indications), 2017 70.510.01.0