Carbamazepine (All indications)

Low Apgar score (< 7) (at 5 min)

id	Study   Auto Bank (Carbamazepine) (Mixed indications), 2017Christensen (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2015Christensen (Carbamazepine) (Controls unexposed NOS) (Mixed indications), 2015Christensen (Carbamazepine) (Controls unexposed, sick) (Mixed indications), 2015Artama (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013Artama (Carbamazepine) (Controls unexposed, disease free), 2013Artama (Carbamazepine) (Controls unexposed, sick), 2013Veiby (Carbamazepine) (Controls exposed to Lamotrigine, sick) b, 2013Veiby (Carbamazepine) (Controls unexposed, disease free) b, 2013Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013Pennell (Carbamazepine), 2012Borthen (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2010Borthen (Carbamazepine) (Controls unexposed, disease free), 2010Borthen (Carbamazepine) (Controls unexposed, sick), 2010	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 R34845	Bank (Carbamazepine) (Mixed indications), 2017	Apgar < 7 at 5 minutes	during pregnancy (anytime or not specified)	prospective cohort	exposed to other treatment, sick	Adjustment: No	4.73 [0.09;258.01] C	0/8   0/36	0	8		ref
S9757 R34839	Christensen (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2015	Low Apgar score (≤ 7) at 5 min	during pregnancy (anytime or not specified)	population based cohort propective	exposed to other treatment, sick excluded	Adjustment: No	2.32 [0.94;5.77] C excluded (control group)	9/344   10/875	19	344		ref
S9758 R34840	Christensen (Carbamazepine) (Controls unexposed NOS) (Mixed indications), 2015	Low Apgar score (≤ 7) at 5 min	during pregnancy (anytime or not specified)	population based cohort propective	unexposed (general population or NOS) excluded	Adjustment: No	2.00 [1.06;3.80] excluded (control group)	9/344   8,797/674,115	8,806	344		ref
S9759 R34841	Christensen (Carbamazepine) (Controls unexposed, sick) (Mixed indications), 2015	Low Apgar score (≤ 7) at 5 min	during pregnancy (anytime or not specified)	population based cohort propective	unexposed, sick	Adjustment: No	2.08 [1.03;4.21] C	9/344   67/5,261	76	344		ref
S9598 R33994	Artama (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013	5-min Apgar <7	3rd trimester	population based cohort retrospective	exposed to other treatment, sick excluded	Adjustment: No	0.35 [0.06;2.12] C excluded (control group)	2/248   3/132	5	248		ref
S9599 R34006	Artama (Carbamazepine) (Controls unexposed, disease free), 2013	5-min Apgar <7	3rd trimester	population based cohort retrospective	unexposed, disease free excluded	Adjustment: Yes	0.85 [0.21;3.42] excluded (control group)	2/248   3,014/269,151	3,016	248		ref
S9600 R34018	Artama (Carbamazepine) (Controls unexposed, sick), 2013	5-min Apgar <7	3rd trimester	population based cohort retrospective	unexposed, sick	Adjustment: Yes	1.08 [0.20;5.15]	2/248   3/652	5	248		ref
S9743 R34759	Veiby (Carbamazepine) (Controls exposed to Lamotrigine, sick) b, 2013	Low Apgar score (< 7 at 5 min)	during pregnancy (anytime or not specified)	prospective cohort	exposed to other treatment, sick excluded	Adjustment: No	0.30 [0.01;6.40] C excluded (control group)	0/67   2/103	2	67		ref
S9745 R34778	Veiby (Carbamazepine) (Controls unexposed, disease free) b, 2013	Low Apgar score (< 7 at 5 min)	during pregnancy (anytime or not specified)	prospective cohort	unexposed, disease free excluded	Adjustment: No	0.46 [0.03;7.47] C excluded (control group)	0/67   1,710/106,899	1,710	67		ref
S9746 R34792	Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013	Low Apgar score (< 7 at 5 min)	during pregnancy (anytime or not specified)	prospective cohort	unexposed, sick	Adjustment: No	0.30 [0.02;5.18] C	0/67   9/386	9	67		ref
S9640 R34298	Pennell (Carbamazepine), 2012	Apgar score (at 5 minutes < 7)	during pregnancy (anytime or not specified)	prospective cohort	exposed to other treatment, sick	Adjustment: No	3.23 [0.13;80.44] C	1/91   0/97	1	91		ref
S9751 R34820	Borthen (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2010	Apgar < 7 after 5 minutes	during pregnancy (anytime or not specified)	population based cohort retrospective	exposed to other treatment, sick excluded	Adjustment: No	0.94 [0.36;2.46] C excluded (control group)	11/388   7/233	18	388		ref
S9753 R34828	Borthen (Carbamazepine) (Controls unexposed, disease free), 2010	Apgar < 7 after 5 minutes	during pregnancy (anytime or not specified)	population based cohort retrospective	unexposed, disease free excluded	Adjustment: Yes	1.70 [0.90;3.10] excluded (control group)	11/388   6,022/362,302	6,033	388		ref
S9755 R34836	Borthen (Carbamazepine) (Controls unexposed, sick), 2010	Apgar < 7 after 5 minutes	during pregnancy (anytime or not specified)	population based cohort retrospective	unexposed, sick	Adjustment: No	1.78 [0.89;3.59] C	11/388   30/1,863	41	388		ref
					Total	6 studies	1.79 [1.13;2.84]		132	1,146
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 9751, 9753, 9598, 9599, 9743, 9745, 9757, 9758