Carbamazepine (All indications)

Low Apgar score (< 7) (at 1 min)

id	Study   Auto Bank (Carbamazepine) (Mixed indications), 2017Artama (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013Artama (Carbamazepine) (Controls unexposed, disease free), 2013Artama (Carbamazepine) (Controls unexposed, sick), 2013Pennell (Carbamazepine), 2012Endo (Carbamazepine) (Controls unexposed, disease free), 2004Endo (Carbamazepine) (Controls unexposed, sick), 2004Van der Pol (Carbamazepine) (Controls unexposed, disease free), 1991Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991	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.
S9760 R34844	Bank (Carbamazepine) (Mixed indications), 2017	Apgar < 7 at 1 minute	during pregnancy (anytime or not specified)	prospective cohort	exposed to other treatment, sick	Adjustment: No	2.43 [0.19;30.63] C	1/8   2/36	3	8		ref
S9598 R33993	Artama (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013	1-min Apgar <7	3rd trimester	population based cohort retrospective	exposed to other treatment, sick excluded	Adjustment: No	0.67 [0.32;1.42] C excluded (control group)	36/904   9/154	45	904		ref
S9599 R34005	Artama (Carbamazepine) (Controls unexposed, disease free), 2013	1-min Apgar <7	3rd trimester	population based cohort retrospective	unexposed, disease free excluded	Adjustment: Yes	1.04 [0.74;1.45] excluded (control group)	36/904   27,939/689,482	27,975	904		ref
S9600 R34017	Artama (Carbamazepine) (Controls unexposed, sick), 2013	1-min Apgar <7	3rd trimester	population based cohort retrospective	unexposed, sick	Adjustment: Yes	1.06 [0.70;1.61]	36/904   69/1,708	105	904		ref
S9640 R34297	Pennell (Carbamazepine), 2012	Apgar score (at 1 minute < 7)	during pregnancy (anytime or not specified)	prospective cohort	exposed to other treatment, sick	Adjustment: No	2.55 [0.76;8.60] C	9/91   4/97	13	91		ref
S9615 R34172	Endo (Carbamazepine) (Controls unexposed, disease free), 2004	Apgar score (<8 at 1min)	throughout pregnancy	retrospective cohort	unexposed, disease free excluded	Adjustment: No	0.71 [0.09;5.89] C excluded (control group)	1/8   47/280	48	8		ref
S9616 R34187	Endo (Carbamazepine) (Controls unexposed, sick), 2004	Apgar score (<8 at 1min)	throughout pregnancy	retrospective cohort	unexposed, sick	Adjustment: No	0.23 [0.00;17.06] C	1/8   0/1	1	8		ref
S9740 R34696	Van der Pol (Carbamazepine) (Controls unexposed, disease free), 1991	Apgar scores (1 minute <7)	throughout pregnancy	prospective cohort	unexposed, disease free excluded	Adjustment: No Matched	1.00 [0.11;9.51] C excluded (control group)	1/11   5/55	6	11		ref
S9741 R34721	Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991	Apgar scores (1 minute <7)	throughout pregnancy	prospective cohort	unexposed, sick	Adjustment: No	2.10 [0.12;37.12] C	1/11   1/22	2	11		ref
					Total	5 studies	1.18 [0.80;1.73]		124	1,022
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 9740, 9615, 9598, 9599