Carbamazepine (All indications)

Neural Tube Defects

id	Study   Auto Tomson (Carbamazepine), 2018Campbell (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2014Vajda (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013Vajda (Carbamazepine) (Controls unexposed, sick), 2013Hernández-Díaz (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2012Bànhidy (Carbamazepine), 2011Mawer (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2010Mawer (Carbamazepine) (Controls unexposed, disease free), 2010Mawer (Carbamazepine) (Controls unexposed, sick), 2010Canger (Carbamazepine), 1999	Lib. in paper	Exposition period  Auto during pregnancy (anytime or not specified)1st trimester2nd trimester3rd trimester2nd and/or 3rd trimesterthroughout pregnancyearly pregnancydays before deliverylate pregnancypreconception-onlypericonceptionalpreconceptional for kinetic reasonat least 1st trimester3 months (or more) before pregnancy or during pregnancy1st and 2nd trimester3 months or more before pregnancy or1st trimester	Study type  All studies Case control excluded Only case control	Control type    Auto unexposed (general population or NOS)unexposed, sickunexposed, disease freeexposed to other treatment, sicknot specifiedwhatever (meta-analysis)	Tags	OR 95%CI	x1/n1 x0/n0	no cases	no exposed	ROB	Ref.
S9678 R34453	Tomson (Carbamazepine), 2018	Neural tube defects	at least 1st trimester	prospective cohort	exposed to other treatment, sick	Adjustment: No	9.02 [1.11;73.39] C	7/1,957   1/2,514	8	1,957		ref
S9655 R34366	Campbell (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2014	Neural tube defect	1st trimester	prospective cohort	exposed to other treatment, sick	Adjustment: No	2.54 [0.46;13.86] C	4/1,657   2/2,098	6	1,657		ref
S10290 R37673	Vajda (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013	Neural Tube Malformations	at least 1st trimester	prospective cohort	exposed to other treatment, sick excluded	Adjustment: No	2.62 [0.11;64.66] C excluded (control group)	1/361   0/315	1	361		ref
S10291 R37679	Vajda (Carbamazepine) (Controls unexposed, sick), 2013	Neural Tube Malformations	at least 1st trimester	prospective cohort	unexposed, sick	Adjustment: No	1.22 [0.05;30.19] C	1/361   0/147	1	361		ref
S9619 R34195	Hernández-Díaz (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2012	Neural tube defects	1st trimester	prospective cohort	exposed to other treatment, sick	Adjustment: No Controls: mixed indications	2.27 [0.38;13.62] C	3/1,033   2/1,562	5	1,033		ref
S9653 R34358	Bànhidy (Carbamazepine), 2011	Neural tube defects	throughout pregnancy	case control	unexposed, sick	Adjustment: No Matched	2.00 [0.16;25.76] C	2/12   1/11	3	12		ref
S9628 R35306	Mawer (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2010	Neural Tube Malformations	1st trimester	prospective cohort	exposed to other treatment, sick excluded	Adjustment: No	0.56 [0.01;28.68] C excluded (control group)	0/66   0/37	0	66		ref
S9629 R35310	Mawer (Carbamazepine) (Controls unexposed, disease free), 2010	Neural Tube Malformations	1st trimester	prospective cohort	unexposed, disease free excluded	Adjustment: No Matched	1.44 [0.06;35.82] C excluded (control group)	0/66   1/285	1	66		ref
S9630 R35314	Mawer (Carbamazepine) (Controls unexposed, sick), 2010	Neural Tube Malformations	1st trimester	prospective cohort	unexposed, sick	Adjustment: No	0.62 [0.01;31.78] C	0/66   0/41	0	66		ref
S9657 R34384	Canger (Carbamazepine), 1999	Neural tube defects	1st trimester	prospective cohort	unexposed, sick	Adjustment: No	0.66 [0.03;16.67] C	1/113   0/25	1	113		ref
					Total	7 studies	2.40 [1.00;5.77]		24	5,199
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

Sensitivity analysis

Publication bias and p-hacking diagnosis

Sub-groups analysis using all included studies

excluded 9628, 9629, 10290