Valproate (All indications)

Gestational diabetes

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.
S9287
R32245		 Aydin (Valproate) (Controls exposed to Lamotrigine, sick), 2020 Gestational diabetes mellitus throughout pregnancy retrospective cohort exposed to other treatment, sick excluded Adjustment: No 0.62 [0.01;35.19] C
excluded (control group) 		0/11   0/7 0 11
ref
S9288
R32255		 Aydin (Valproate) (Controls unexposed, sick), 2020 Gestational diabetes mellitus throughout pregnancy retrospective cohort unexposed, sick Adjustment: No 0.65 [0.02;17.40] C 0/11   1/22 1 11
ref
S9450
R33182		 Rihtman (Valproate) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2013 Mothers: gestational diabetes in pregnancy at least 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No Controls: epilepsy indication 18.49 [0.98;349.67] C
excluded (control group) 		5/29   0/40 5 29
ref
S9451
R33217		 Rihtman (Valproate) (Controls unexposed, NOS) (Mixed indications), 2013 Mothers: gestational diabetes in pregnancy at least 1st trimester prospective cohort unexposed (general population or NOS) Adjustment: No 23.64 [1.25;445.44] C 5/29   0/51 5 29
ref
S9323
R32489		 Pennell (Valproate), 2012 Gestational Diabetes during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick Adjustment: No 0.31 [0.03;2.69] C 1/61   5/97 6 61
ref
S9411
R32994		 McVearry (Valproate), 2009 Gestational diabetes during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick Adjustment: No 2.13 [0.12;38.48] C 1/9   1/18 2 9
ref
Total 4 studies 1.60 [0.23;10.91] 14 110
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 Aydin (Valproate) (Controls unexposed, sick), 2020Aydin, 2020 1 0.65[0.02; 17.40]11121%ROB confusion: criticalROB selection: criticalROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Rihtman (Valproate) (Controls unexposed, NOS) (Mixed indications), 2013Rihtman, 2013 2 23.64[1.25; 445.44]52924%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Pennell (Valproate), 2012Pennell, 2012 3 0.31[0.03; 2.69]66132%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA McVearry (Valproate), 2009McVearry, 2009 4 2.13[0.12; 38.48]2924%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (4 studies) I2 = 48% 1.60[0.23; 10.91]141100.250.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

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

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.60[0.23; 10.91]1411048%NAAydin (Valproate) (Controls unexposed, sick), 2020 Rihtman (Valproate) (Controls unexposed, NOS) (Mixed indications), 2013 Pennell (Valproate), 2012 McVearry (Valproate), 2009 4 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 23.64[1.25; 445.44]529 -NARihtman (Valproate) (Controls unexposed, NOS) (Mixed indications), 2013 1 unexposed, sickunexposed, sick 0.65[0.02; 17.40]111 -NAAydin (Valproate) (Controls unexposed, sick), 2020 1 exposed to other treatment, sickexposed to other treatment, sick 0.63[0.10; 3.95]8709%NAPennell (Valproate), 2012 McVearry (Valproate), 2009 2 Tags Adjustment   - No  - No 1.60[0.23; 10.91]1411048%NAAydin (Valproate) (Controls unexposed, sick), 2020 Rihtman (Valproate) (Controls unexposed, NOS) (Mixed indications), 2013 Pennell (Valproate), 2012 McVearry (Valproate), 2009 4 All studiesAll studies 1.60[0.23; 10.91]1411048%NAAydin (Valproate) (Controls unexposed, sick), 2020 Rihtman (Valproate) (Controls unexposed, NOS) (Mixed indications), 2013 Pennell (Valproate), 2012 McVearry (Valproate), 2009 40.150.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.94.42.0120.000Aydin (Valproate) (Controls unexposed, sick), 2020Rihtman (Valproate) (Controls unexposed, NOS) (Mixed indications), 2013Pennell (Valproate), 2012McVearry (Valproate), 2009

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 9450, 9287

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) Out of scale23.64[1.25; 445.44]529 -NARihtman (Valproate) (Controls unexposed, NOS) (Mixed indications), 2013 1 unexposed, sick controlsunexposed, sick controls 0.65[0.02; 17.40]111 -NAAydin (Valproate) (Controls unexposed, sick), 2020 1 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.54[0.23; 10.18]1311041%NAAydin (Valproate) (Controls exposed to Lamotrigine, sick), 2020 Rihtman (Valproate) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2013 Pennell (Valproate), 2012 McVearry (Valproate), 2009 40.510.01.0