Valproate (All indications)

Emotional disorders

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.
S15237
R62624		 Dreier (Valproate) (Epilepsy) (Controls exposed to LTG), 2023 Mood disorder - Corresponding ICD-10 F-chapter - Up to 22 years of age during pregnancy (anytime or not specified) population based cohort propective exposed to other treatment, sick excluded Adjustment: No 6.29 [2.99;13.25] C
excluded (control group) 		23/1,952   10/5,288 33 1,952
ref
S15228
R62507		 Dreier (Valproate) (Epilepsy) (Controls unexposed, sick), 2023 Anxiety disorder - Corresponding ICD-10 F-chapter - Up to 22 years of age during pregnancy (anytime or not specified) population based cohort propective unexposed, sick Adjustment: Yes 1.00 [0.77;1.31] 104/1,952   458/22,203 562 1,952
ref
S9404
R32968		 Huber-Mollema (Valproate), 2019 Internalizing problems (The Child Behavior Checklist) (Completed by mothers) throughout pregnancy prospective cohort exposed to other treatment, sick Adjustment: No 0.67 [0.22;1.98] C 5/25   24/88 29 25
ref
S9374
R32794		 Bromley (Valproate), 2016 Maladaptive behavior: Anxiety (BASC) (5-9 years old) during pregnancy (anytime or not specified) retrospective cohort (registry) unexposed, sick Adjustment: No extrapolated (cont. endpoint) 1.04 [0.51;2.11] -/47   -/55 - 47
ref
S9390
R32868		 Cohen (Valproate), 2013 Anxiety in mean (BASC scale) (Parent ratings) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick Adjustment: Yes extrapolated (cont. endpoint) 0.84 [0.42;1.68] -/45   -/61 - 45
ref
Total 4 studies 0.97 [0.77;1.22] 591 2,069
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 Dreier (Valproate) (Epilepsy) (Controls unexposed, sick), 2023Dreier, 2023 1 1.00[0.77; 1.31]5621,95274%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Huber-Mollema (Valproate), 2019Huber-Mollema, 2019 2 0.67[0.22; 1.98]29254%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: criticalROB mesure: moderateROB reporting: moderate Bromley (Valproate), 2016Bromley, 2016 3 1.04[0.51; 2.11]-4710%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Cohen (Valproate), 2013Cohen, 2013 4 0.84[0.42; 1.68]-4511%ROB confusion: moderateROB selection: lowROB classification: lowROB missing: criticalROB mesure: lowROB reporting: low Total (4 studies) I2 = 0% 0.97[0.77; 1.22]5912,0690.25.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Valproate) (Epilepsy) (Controls unexposed, sick; 2: Valproate; 3: Valproate; 4: Valproate;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 0.97[0.77; 1.22]5912,0690%NADreier (Valproate) (Epilepsy) (Controls unexposed, sick), 2023 Huber-Mollema (Valproate), 2019 Bromley (Valproate), 2016 Cohen (Valproate), 2013 4 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 1.00[0.78; 1.29]5621,9990%NADreier (Valproate) (Epilepsy) (Controls unexposed, sick), 2023 Bromley (Valproate), 2016 2 exposed to other treatment, sickexposed to other treatment, sick 0.79[0.44; 1.41]29700%NAHuber-Mollema (Valproate), 2019 Cohen (Valproate), 2013 2 Tags Adjustment   - No  - No 0.91[0.50; 1.65]29720%NAHuber-Mollema (Valproate), 2019 Bromley (Valproate), 2016 2   - Yes  - Yes 0.98[0.76; 1.25]5621,9970%NADreier (Valproate) (Epilepsy) (Controls unexposed, sick), 2023 Cohen (Valproate), 2013 2 extrapolated (cont. endpoint)extrapolated (cont. endpoint) 0.93[0.57; 1.53]-920%NABromley (Valproate), 2016 Cohen (Valproate), 2013 2 All studiesAll studies 0.97[0.77; 1.22]5912,0690%NADreier (Valproate) (Epilepsy) (Controls unexposed, sick), 2023 Huber-Mollema (Valproate), 2019 Bromley (Valproate), 2016 Cohen (Valproate), 2013 40.25.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-1.31.30.6650.000Dreier (Valproate) (Epilepsy) (Controls unexposed, sick), 2023Huber-Mollema (Valproate), 2019Bromley (Valproate), 2016Cohen (Valproate), 2013

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 15237

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed, sick controlsunexposed, sick controls 1.00[0.78; 1.29]5621,9990%NADreier (Valproate) (Epilepsy) (Controls unexposed, sick), 2023 Bromley (Valproate), 2016 2 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.56[0.36; 6.66]622,02289%NADreier (Valproate) (Epilepsy) (Controls exposed to LTG), 2023 Huber-Mollema (Valproate), 2019 Cohen (Valproate), 2013 30.510.01.0