Valproate (All indications)

Macrosomia (> 4000g)

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.
S9391
R32875		 Coste (Valproate) (Controls exposed to Lamotrigine, sick), 2020 Weight at birth (≥3500 g) during pregnancy (anytime or not specified) retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: No 0.92 [0.78;1.08] C
excluded (control group) 		287/991   648/2,108 935 991
ref
S9392
R32893		 Coste (Valproate) (Controls unexposed, NOS), 2020 Weight at birth (≥3500 g) during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No 0.80 [0.70;0.92] C 287/991   577,097/1,710,441 577,384 991
ref
S9346
R32597		 Kini (Valproate) (Controls unexposed, sick), 2006 Birth weight >4000 g during pregnancy (anytime or not specified) retrospective cohort unexposed, sick Adjustment: No 1.57 [0.65;3.81] C 11/63   12/101 23 63
ref
S9301
R32400		 Endo (Valproate) (Controls unexposed, sick), 2004 Birth weight > 4,000g throughout pregnancy retrospective cohort unexposed, sick Adjustment: No 0.11 [0.00;14.76] C 0/5   0/1 0 5
ref
Total 3 studies 0.91 [0.55;1.51] 577,407 1,059
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 (Valproate) (Controls unexposed, NOS), 2020Coste, 2020 1 0.80[0.70; 0.92]577,38499176%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Kini (Valproate) (Controls unexposed, sick), 2006Kini, 2006 2 1.57[0.65; 3.81]236323%ROB confusion: criticalROB selection: criticalROB classification: lowROB missing: unclearROB mesure: moderateROB reporting: moderate Endo (Valproate) (Controls unexposed, sick), 2004Endo, 2004 3 0.11[0.00; 14.76]051%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (3 studies) I2 = 28% 0.91[0.55; 1.51]577,4071,0590.05.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

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

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 0.91[0.55; 1.51]577,4071,05928%NACoste (Valproate) (Controls unexposed, NOS), 2020 Kini (Valproate) (Controls unexposed, sick), 2006 Endo (Valproate) (Controls unexposed, sick), 2004 3 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 0.80[0.70; 0.92]577,384991 -NACoste (Valproate) (Controls unexposed, NOS), 2020 1 unexposed, sickunexposed, sick 1.30[0.34; 4.92]23688%NAKini (Valproate) (Controls unexposed, sick), 2006 Endo (Valproate) (Controls unexposed, sick), 2004 2 Tags Adjustment   - No  - No 0.91[0.55; 1.51]577,4071,05928%NACoste (Valproate) (Controls unexposed, NOS), 2020 Kini (Valproate) (Controls unexposed, sick), 2006 Endo (Valproate) (Controls unexposed, sick), 2004 3 All studiesAll studies 0.91[0.55; 1.51]577,4071,05928%NACoste (Valproate) (Controls unexposed, NOS), 2020 Kini (Valproate) (Controls unexposed, sick), 2006 Endo (Valproate) (Controls unexposed, sick), 2004 30.05.01.0

Publication bias and p-hacking diagnosis

funnel plot

Funnel plot not drawn. Less than 3 points.

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

not enought points

p values plot

Funnel plot not drawn. Less than 3 points.

Sub-groups analysis using all included studies

excluded 9391

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 0.80[0.70; 0.92]577,384991 -NACoste (Valproate) (Controls unexposed, NOS), 2020 1 unexposed, sick controlsunexposed, sick controls 1.30[0.34; 4.92]23688%NAKini (Valproate) (Controls unexposed, sick), 2006 Endo (Valproate) (Controls unexposed, sick), 2004 2 exposed to other treatment, sick controlsexposed to other treatment, sick controls 0.92[0.78; 1.08]935991 -NACoste (Valproate) (Controls exposed to Lamotrigine, sick), 2020 10.510.01.0