Phenobarbital (All indications)

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.
S9160
R31486
Coste (Phenobarbital) (Controls exposed to Lamotrigine, sick), 2020 Small for gestational age (weight) during pregnancy (anytime or not specified) retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: No Controls: mixed indications 2.26 [1.31;3.90] C
excluded (control group)
17/84   284/2,813 301 84
ref
S9161
R31504
Coste (Phenobarbital) (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 2.34 [1.37;3.98] C 17/84   167,376/1,710,441 167,393 84
ref
S9159
R31478
Hernández-Díaz (Phenobarbital), 2017 Small for gestational age (<10th percentile) throughout pregnancy prospective cohort exposed to other treatment, sick Adjustment: Yes 2.40 [1.60;3.60] -/178   -/1,799 - 178
ref
S9138
R31382
Kilic (Phenobarbital) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2014 Small for gestational age (birth weight <10% percentile for the gestational birth week) during pregnancy (anytime or not specified) population based cohort retrospective exposed to other treatment, sick excluded Adjustment: No 2.36 [1.34;4.14] C
excluded (control group)
18/96   78/876 96 96
ref
S9139
R31385
Kilic (Phenobarbital) (Controls unexposed NOS) (Mixed indications), 2014 Small for gestational age (birth weight <10% percentile for the gestational birth week) during pregnancy (anytime or not specified) population based cohort retrospective unexposed (general population or NOS) excluded Adjustment: No 1.90 [1.30;2.90]
excluded (control group)
18/96   65,118/673,844 65,136 96
ref
S9140
R31388
Kilic (Phenobarbital) (Controls unexposed, sick) (Mixed indications), 2014 Small for gestational age (birth weight <10% percentile for the gestational birth week) during pregnancy (anytime or not specified) population based cohort retrospective unexposed, sick Adjustment: No Controls: epilepsy indication 1.82 [1.08;3.06] C 18/96   594/5,275 612 96
ref
S9099
R31167
Burja (Phenobarbital) (Controls unexposed, disease free), 2006 Small for date (NOS) during pregnancy (anytime or not specified) retrospective cohort (registry) unexposed, disease free excluded Adjustment: No 7.98 [0.15;411.65] C
excluded (control group)
0/1   23/211 23 1
ref
S9100
R31172
Burja (Phenobarbital) (Controls unexposed, sick), 2006 Small for date (NOS) during pregnancy (anytime or not specified) retrospective cohort (registry) unexposed, sick Adjustment: No 20.33 [0.29;1423.95] C 0/1   1/32 1 1
ref
S9104
R31252
Endo (Phenobarbital) (Controls unexposed, disease free), 2004 Intrauterine growth retardation (NOS) throughout pregnancy retrospective cohort unexposed, disease free excluded Adjustment: No 0.95 [0.05;16.63] C
excluded (control group)
0/10   34/656 34 10
ref
S9105
R31267
Endo (Phenobarbital) (Controls unexposed, sick), 2004 Intrauterine growth retardation (NOS) throughout pregnancy retrospective cohort unexposed, sick Adjustment: No 0.05 [0.00;6.68] C 0/10   0/1 0 10
ref
Total 5 studies 2.20 [1.66;2.91] 168,006 369
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 Coste (Phenobarbital) (Controls unexposed, NOS), 2020Coste, 2020 1 2.34[1.37; 3.98]167,3938427%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Hernández-Díaz (Phenobarbital), 2017Hernández-Díaz, 2017 2 2.40[1.60; 3.60]-17845%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Kilic (Phenobarbital) (Controls unexposed, sick) (Mixed indications), 2014Kilic, 2014 3 1.82[1.08; 3.06]6129628%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Burja (Phenobarbital) (Controls unexposed, sick), 2006Burja, 2006 4 20.33[0.29; 1423.95]110%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Endo (Phenobarbital) (Controls unexposed, sick), 2004Endo, 2004 5 0.05[0.00; 6.68]0100%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (5 studies) I2 = 2% 2.20[1.66; 2.91]168,0063690.050.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Phenobarbital) (Controls unexposed, NOS; 2: Phenobarbital; 3: Phenobarbital) (Controls unexposed, sick) (Mixed indications; 4: Phenobarbital) (Controls unexposed, sick; 5: Phenobarbital) (Controls unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 2.20[1.66; 2.91]168,0063692%NACoste (Phenobarbital) (Controls unexposed, NOS), 2020 Hernández-Díaz (Phenobarbital), 2017 Kilic (Phenobarbital) (Controls unexposed, sick) (Mixed indications), 2014 Burja (Phenobarbital) (Controls unexposed, sick), 2006 Endo (Phenobarbital) (Controls unexposed, sick), 2004 5 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 2.34[1.37; 3.98]167,39384 -NACoste (Phenobarbital) (Controls unexposed, NOS), 2020 1 unexposed, sickunexposed, sick 1.66[0.19; 14.25]61310739%NAKilic (Phenobarbital) (Controls unexposed, sick) (Mixed indications), 2014 Burja (Phenobarbital) (Controls unexposed, sick), 2006 Endo (Phenobarbital) (Controls unexposed, sick), 2004 3 exposed to other treatment, sickexposed to other treatment, sick 2.40[1.60; 3.60]-178 -NAHernández-Díaz (Phenobarbital), 2017 1 Tags Adjustment   - No  - No 2.04[1.26; 3.32]168,00619120%NACoste (Phenobarbital) (Controls unexposed, NOS), 2020 Kilic (Phenobarbital) (Controls unexposed, sick) (Mixed indications), 2014 Burja (Phenobarbital) (Controls unexposed, sick), 2006 Endo (Phenobarbital) (Controls unexposed, sick), 2004 4   - Yes  - Yes 2.40[1.60; 3.60]-178 -NAHernández-Díaz (Phenobarbital), 2017 1 Controls   - epilepsy indication  - epilepsy indication 1.82[1.08; 3.06]61296 -NAKilic (Phenobarbital) (Controls unexposed, sick) (Mixed indications), 2014 1 All studiesAll studies 2.20[1.66; 2.91]168,0063692%NACoste (Phenobarbital) (Controls unexposed, NOS), 2020 Hernández-Díaz (Phenobarbital), 2017 Kilic (Phenobarbital) (Controls unexposed, sick) (Mixed indications), 2014 Burja (Phenobarbital) (Controls unexposed, sick), 2006 Endo (Phenobarbital) (Controls unexposed, sick), 2004 50.050.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-5.86.62.9650.000Coste (Phenobarbital) (Controls unexposed, NOS), 2020Hernández-Díaz (Phenobarbital), 2017Kilic (Phenobarbital) (Controls unexposed, sick) (Mixed indications), 2014Burja (Phenobarbital) (Controls unexposed, sick), 2006Endo (Phenobarbital) (Controls unexposed, sick), 2004

Asymetry test p-value = 0.7261 (by Egger's regression)

slope=0.8760 (0.2767); intercept=-0.3417 (0.8882); t=0.3847; p=0.7261

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 9104, 9099, 9138, 9139, 9160

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 2.05[1.49; 2.81]232,5861910%NACoste (Phenobarbital) (Controls unexposed, NOS), 2020 Kilic (Phenobarbital) (Controls unexposed NOS) (Mixed indications), 2014 Burja (Phenobarbital) (Controls unexposed, disease free), 2006 Endo (Phenobarbital) (Controls unexposed, disease free), 2004 4 unexposed, sick controlsunexposed, sick controls 1.66[0.19; 14.25]61310739%NAKilic (Phenobarbital) (Controls unexposed, sick) (Mixed indications), 2014 Burja (Phenobarbital) (Controls unexposed, sick), 2006 Endo (Phenobarbital) (Controls unexposed, sick), 2004 3 exposed to other treatment, sick controlsexposed to other treatment, sick controls 2.35[1.77; 3.12]3973580%NACoste (Phenobarbital) (Controls exposed to Lamotrigine, sick), 2020 Hernández-Díaz (Phenobarbital), 2017 Kilic (Phenobarbital) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2014 30.510.01.0