Carbamazepine (All indications)

Neonatal medical care

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.
S15367
R63237
Bromley (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2023 Neonatal special care admission during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No 0.54 [0.15;1.96] C
excluded (control group)
3/27   20/106 23 27
ref
S15368
R63250
Bromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Neonatal special care admission during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No 1.54 [0.36;6.64] C 3/27   6/80 9 27
ref
S9602
R34032
Aydin (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2020 Neonatal intensive care unit (NICU) throughout pregnancy retrospective cohort exposed to other treatment, sick excluded Adjustment: No 0.38 [0.04;3.52] C
excluded (control group)
2/15   2/7 4 15
ref
S9603
R34042
Aydin (Carbamazepine) (Controls unexposed, sick), 2020 Neonatal intensive care unit (NICU) throughout pregnancy retrospective cohort unexposed, sick Adjustment: No 1.54 [0.19;12.32] C 2/15   2/22 4 15
ref
S9760
R34846
Bank (Carbamazepine) (Mixed indications), 2017 Admission to neonatal intensive care unit (NICU) or Special Care Nursery during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick Adjustment: No 1.67 [0.27;10.33] C 2/8   6/36 8 8
ref
S9598
R33992
Artama (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013 Admission to neonatal care unit 3rd trimester population based cohort retrospective exposed to other treatment, sick excluded Adjustment: No 0.59 [0.36;0.96] C
excluded (control group)
89/904   24/154 113 904
ref
S9599
R34004
Artama (Carbamazepine) (Controls unexposed, disease free), 2013 Admission to neonatal care unit 3rd trimester population based cohort retrospective unexposed, disease free excluded Adjustment: Yes 1.44 [1.16;1.80]
excluded (control group)
89/904   49,612/689,482 49,701 904
ref
S9600
R34016
Artama (Carbamazepine) (Controls unexposed, sick), 2013 Admission to neonatal care unit 3rd trimester population based cohort retrospective unexposed, sick Adjustment: Yes 1.17 [0.88;1.55] 89/904   152/1,708 241 904
ref
S9647
R34330
Viinikainen (Carbamazepine) (Controls unexposed, disease free) a, 2006 Admission to a neonatal unit throughout pregnancy prospective cohort unexposed, disease free Adjustment: No 1.15 [0.50;2.65] C 6/72   1,822/24,778 1,828 72
ref
S9612
R34110
D'Souza (Carbamazepine) (Controls unexposed, disease free), 1991 Idiopathic respiratory distress throughout pregnancy prospective cohort unexposed, disease free excluded Adjustment: No Matched 24.60 [0.40;1512.72] C
excluded (control group)
0/3   0/62 0 3
ref
S9613
R34139
D'Souza (Carbamazepine) (Controls unexposed, sick), 1991 Idiopathic respiratory distress throughout pregnancy prospective cohort unexposed, sick Adjustment: No 3.00 [0.05;194.76] C 0/3   0/8 0 3
ref
Total 6 studies 1.20 [0.92;1.55] 2,090 1,029
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 Bromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023Bromley, 2023 1 1.54[0.36; 6.64]9273%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: moderateROB mesure: moderateROB reporting: low Aydin (Carbamazepine) (Controls unexposed, sick), 2020Aydin, 2020 2 1.54[0.19; 12.32]4152%ROB confusion: criticalROB selection: criticalROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Bank (Carbamazepine) (Mixed indications), 2017Bank, 2017 3 1.67[0.27; 10.33]882%ROB confusion: criticalROB selection: lowROB classification: lowROB missing: lowROB mesure: moderateROB reporting: moderate Artama (Carbamazepine) (Controls unexposed, sick), 2013Artama, 2013 4 1.17[0.88; 1.55]24190483%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Viinikainen (Carbamazepine) (Controls unexposed, disease free) a, 2006Viinikainen, 2006 5 1.15[0.50; 2.65]1,8287210%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate D'Souza (Carbamazepine) (Controls unexposed, sick), 1991D'Souza, 1991 6 3.00[0.05; 194.76]030%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (6 studies) I2 = 0% 1.20[0.92; 1.55]2,0901,0290.510.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Carbamazepine) (Epilepsy) (Controls unexposed, sick; 2: Carbamazepine) (Controls unexposed, sick; 3: Carbamazepine) (Mixed indications; 4: Carbamazepine) (Controls unexposed, sick; 5: Carbamazepine) (Controls unexposed, disease free) ; 6: Carbamazepine) (Controls unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.20[0.92; 1.55]2,0901,0290%NABromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Aydin (Carbamazepine) (Controls unexposed, sick), 2020 Bank (Carbamazepine) (Mixed indications), 2017 Artama (Carbamazepine) (Controls unexposed, sick), 2013 Viinikainen (Carbamazepine) (Controls unexposed, disease free) a, 2006 D'Souza (Carbamazepine) (Controls unexposed, sick), 1991 6 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.15[0.50; 2.65]1,82872 -NAViinikainen (Carbamazepine) (Controls unexposed, disease free) a, 2006 1 unexposed, sickunexposed, sick 1.19[0.91; 1.57]2549490%NABromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Aydin (Carbamazepine) (Controls unexposed, sick), 2020 Artama (Carbamazepine) (Controls unexposed, sick), 2013 D'Souza (Carbamazepine) (Controls unexposed, sick), 1991 4 exposed to other treatment, sickexposed to other treatment, sick 1.67[0.27; 10.33]88 -NABank (Carbamazepine) (Mixed indications), 2017 1 Tags Adjustment   - No  - No 1.33[0.71; 2.51]1,8491250%NABromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Aydin (Carbamazepine) (Controls unexposed, sick), 2020 Bank (Carbamazepine) (Mixed indications), 2017 Viinikainen (Carbamazepine) (Controls unexposed, disease free) a, 2006 D'Souza (Carbamazepine) (Controls unexposed, sick), 1991 5   - Yes  - Yes 1.17[0.88; 1.55]241904 -NAArtama (Carbamazepine) (Controls unexposed, sick), 2013 1 All studiesAll studies 1.20[0.92; 1.55]2,0901,0290%NABromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Aydin (Carbamazepine) (Controls unexposed, sick), 2020 Bank (Carbamazepine) (Mixed indications), 2017 Artama (Carbamazepine) (Controls unexposed, sick), 2013 Viinikainen (Carbamazepine) (Controls unexposed, disease free) a, 2006 D'Souza (Carbamazepine) (Controls unexposed, sick), 1991 60.510.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-5.05.22.5550.000Bromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023Aydin (Carbamazepine) (Controls unexposed, sick), 2020Bank (Carbamazepine) (Mixed indications), 2017Artama (Carbamazepine) (Controls unexposed, sick), 2013Viinikainen (Carbamazepine) (Controls unexposed, disease free) a, 2006D'Souza (Carbamazepine) (Controls unexposed, sick), 1991

Asymetry test p-value = 0.0165 (by Egger's regression)

slope=0.0942 (0.0301); intercept=0.3706 (0.0932); t=3.9757; p=0.0165

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 9612, 9598, 9599, 9602, 15367

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.42[1.08; 1.88]51,5299795%NAArtama (Carbamazepine) (Controls unexposed, disease free), 2013 Viinikainen (Carbamazepine) (Controls unexposed, disease free) a, 2006 D'Souza (Carbamazepine) (Controls unexposed, disease free), 1991 3 unexposed, sick controlsunexposed, sick controls 1.19[0.91; 1.57]2549490%NABromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Aydin (Carbamazepine) (Controls unexposed, sick), 2020 Artama (Carbamazepine) (Controls unexposed, sick), 2013 D'Souza (Carbamazepine) (Controls unexposed, sick), 1991 4 exposed to other treatment, sick controlsexposed to other treatment, sick controls 0.61[0.40; 0.94]1489540%NABromley (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2023 Aydin (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2020 Bank (Carbamazepine) (Mixed indications), 2017 Artama (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013 40.510.01.0