Carbamazepine (All indications)

Major congenital malformations

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
R63239
Bromley (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2023 Major congenital anomaly during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No 2.75 [0.44;17.33] C
excluded (control group)
2/27   3/106 5 27
ref
S15368
R63252
Bromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Major congenital anomaly during pregnancy (anytime or not specified) excluded prospective cohort unexposed, sick Adjustment: No 2.05 [0.32;13.00] C
excluded (exposition period)
2/27   3/80 5 27
ref
S15199
R62341
Cohen (Carbamazepine) (Mixed indications) (Controls exposed to LTG), 2023 Major congenital malformations (excluding genetic/chromosomal) 1st trimester population based cohort retrospective exposed to other treatment, sick excluded Adjustment: Yes Partial overlapping 0.91 [0.72;1.15]
excluded (control group)
90/2,674   314/8,339 404 2,674
ref
S15198
R62334
Cohen (Carbamazepine) (Mixed indications) (Controls unexposed, NOS), 2023 Major congenital malformations (excluding genetic/chromosomal) 1st trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: No Partial overlapping 1.11 [0.90;1.37] C 90/2,674   147,928/4,866,362 148,018 2,674
ref
S15852
R65260
Li (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2023 Major congenital malformation during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No 9.55 [0.47;192.46] C
excluded (control group)
3/31   0/38 3 31
ref
S15267
R62752
Li (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Major congenital malformation during pregnancy (anytime or not specified) excluded prospective cohort unexposed, sick Adjustment: No 3.77 [0.92;15.39] C
excluded (exposition period)
3/31   7/253 10 31
ref
S12674
R47886
Mari (Carbamazepine), 2022 Major foetal malformation throughout pregnancy retrospective cohort exposed to other treatment, sick Adjustment: No 1.15 [0.04;30.40] C 1/29   0/11 1 29
ref
S10225
R37454
The NAAED (Controls exposed to Lamotrigine, sick) (Indications NOS), 2022 Major congenital malformations 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No 1.48 [0.93;2.35] C
excluded (control group)
31/1,122   44/2,333 75 1,122
ref
S10226
R37460
The NAAED (Controls unexposed, disease free) (Indications NOS), 2022 Major congenital malformations 1st trimester prospective cohort unexposed, disease free Adjustment: No 2.82 [1.44;5.51] C 31/1,122   12/1,201 43 1,122
ref
S12683
R47919
Alsfouk (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2021 Major congenital malformation during pregnancy (anytime or not specified) retrospective cohort exposed to other treatment, sick excluded Adjustment: No 1.25 [0.21;7.34] C
excluded (control group)
5/31   2/15 7 31
ref
S12680
R47916
Alsfouk (Carbamazepine) (Controls unexposed, sick), 2021 Major congenital malformation during pregnancy (anytime or not specified) excluded retrospective cohort unexposed, sick Adjustment: No 5.58 [0.61;50.91] C
excluded (exposition period)
5/31   1/30 6 31
ref
S12903
R48938
Hosny (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2021 Major birth defects 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No 0.05 [0.00;3.56] C
excluded (control group)
1/31   0/1 1 31
ref
S12904
R48941
Hosny (Carbamazepine) (Controls unexposed, sick), 2021 Major birth defects 1st trimester prospective cohort unexposed, sick Adjustment: No 0.67 [0.04;11.29] C 1/31   1/21 2 31
ref
S12856
R48493
Thomas (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2021 Major congenital malformations 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No 2.41 [0.32;18.26] C
excluded (control group)
23/490   1/50 24 490
ref
S12857
R48501
Thomas (Carbamazepine) (Controls unexposed, disease free), 2021 Major congenital malformations 1st trimester prospective cohort unexposed, disease free excluded Adjustment: No 1.57 [0.77;3.20]
excluded (control group)
21/389   11/319 32 389
ref
S12858
R48505
Thomas (Carbamazepine) (Controls unexposed, sick), 2021 Major congenital malformations 1st trimester prospective cohort unexposed, sick Adjustment: Yes 0.99 [0.50;1.80] 23/490   16/340 39 490
ref
S9595
R33978
AlSheikh (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2020 Fetal/neonatal malformation during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No 16.71 [0.56;499.27] C
excluded (control group)
1/5   0/20 1 5
ref
S9596
R33981
AlSheikh (Carbamazepine) (Controls unexposed, sick), 2020 Fetal/neonatal malformation during pregnancy (anytime or not specified) excluded prospective cohort unexposed, sick Adjustment: No 1.75 [0.08;36.29] C
excluded (exposition period)
1/5   1/8 2 5
ref
S9632
R34252
Meador (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2020 Major congenital malformations 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No 1.62 [0.17;14.92] C
excluded (control group)
1/14   5/110 6 14
ref
S9633
R34256
Meador (Carbamazepine) (Controls unexposed, disease free), 2020 Major congenital malformations 1st trimester prospective cohort unexposed, disease free excluded Adjustment: No 4.00 [0.34;47.23] C
excluded (control group)
1/14   2/106 3 14
ref
S9634
R34260
Meador (Carbamazepine) (Controls unexposed, sick), 2020 Major congenital malformations 1st trimester prospective cohort unexposed, sick Adjustment: No 1.08 [0.06;19.05] C 1/14   1/15 2 14
ref
S9723
R34624
Huber-Mollema (Carbamazepine), 2019 Congenital malformations throughout pregnancy prospective cohort exposed to other treatment, sick Adjustment: No 2.55 [0.60;10.78] C 4/37   4/88 8 37
ref
S9679
R34459
Vajda (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2019 Fetal malformations at least 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No 1.20 [0.65;2.21] C
excluded (control group)
24/409   20/406 44 409
ref
S9680
R34460
Vajda (Carbamazepine) (Controls unexposed, sick), 2019 Fetal malformations at least 1st trimester prospective cohort unexposed, sick Adjustment: No 2.07 [0.80;5.33] 24/409   5/176 29 409
ref
S9678
R34449
Tomson (Carbamazepine), 2018 Major congenital malformation at least 1st trimester prospective cohort exposed to other treatment, sick Adjustment: No 1.91 [1.41;2.58] C 107/1,957   74/2,514 181 1,957
ref
S9760
R34847
Bank (Carbamazepine) (Mixed indications), 2017 Major Malformation during pregnancy (anytime or not specified) excluded prospective cohort exposed to other treatment, sick Adjustment: No 16.38 [0.60;447.84] C
excluded (exposition period)
1/8   0/36 1 8
ref
S9597
R33984
Arkilo (Carbamazepine), 2015 Major malformations during pregnancy (anytime or not specified) excluded retrospective cohort exposed to other treatment, sick Adjustment: No 1.39 [0.03;73.79] C
excluded (exposition period)
0/16   0/22 0 16
ref
S9763
R34863
Ban (Carbamazepine) (Mixed indications) (Controls exposed to Lamotrigine, sick), 2015 Any major anomaly 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No 0.86 [0.38;1.91] C
excluded (control group)
13/343   12/273 25 343
ref
S9764
R34869
Ban (Carbamazepine) (Mixed indications) (Controls unexposed NOS), 2015 Any major anomaly 1st trimester prospective cohort unexposed (general population or NOS) Adjustment: Yes 1.42 [0.68;2.93] 13/343   6,922/257,153 6,935 343
ref
S9605
R34053
Barroso (Carbamazepine), 2015 Major anomalies during pregnancy (anytime or not specified) excluded retrospective cohort unexposed, disease free Adjustment: No 1.35 [0.17;10.95] C
excluded (exposition period)
1/12   20/316 21 12
ref
S9681
R34461
Vanya (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2015 Major congenital malformations throughout pregnancy retrospective cohort exposed to other treatment, sick excluded Adjustment: No 1.94 [0.07;56.76] C
excluded (control group)
1/10   0/6 1 10
ref
S9682
R34463
Vanya (Carbamazepine) (Controls unexposed, sick), 2015 Major congenital malformations throughout pregnancy retrospective cohort unexposed, sick Adjustment: No 6.88 [0.25;186.69] C 1/10   0/20 1 10
ref
S9655
R34376
Campbell (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2014 Major malformations 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No 1.10 [0.70;1.70]
excluded (control group)
43/1,657   49/2,098 92 1,657
ref
S9656
R34378
Campbell (Carbamazepine) (Controls unexposed, sick), 2014 Major malformations 1st trimester prospective cohort unexposed, sick Adjustment: No 1.08 [0.58;2.03] C 43/1,657   13/541 56 1,657
ref
S9643
R34317
Veiby (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2014 Major congenital malformation throughout pregnancy population based cohort retrospective exposed to other treatment, sick excluded Adjustment: No Partial overlapping 0.86 [0.48;1.55] C
excluded (control group)
20/685   28/833 48 685
ref
S9645
R34325
Veiby (Carbamazepine) (Controls unexposed, disease free) (Mixed indications), 2014 Major malformations throughout pregnancy population based cohort retrospective unexposed, disease free excluded Adjustment: Yes Partial overlapping 1.06 [0.68;1.66]
excluded (control group)
20/685   22,371/771,412 22,391 685
ref
S9646
R34328
Veiby (Carbamazepine) (Controls unexposed, sick) (Mixed indications), 2014 Major malformations throughout pregnancy population based cohort retrospective unexposed, sick Adjustment: No Controls: epilepsy indication Partial overlapping 1.04 [0.64;1.69] C 20/685   106/3,773 126 685
ref
S9658
R34388
Cassina (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2013 Major congenital anomalies 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No 6.94 [0.39;122.72] C
excluded (control group)
8/120   0/46 8 120
ref
S9659
R34390
Cassina (Carbamazepine) (Controls unexposed, disease free) (Mixed indications), 2013 Major congenital anomalies 1st trimester prospective cohort unexposed, disease free Adjustment: No 2.22 [0.98;5.05] C 8/120   25/803 33 120
ref
S9625
R34223
Källén (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Indications NOS), 2013 Relatively severe malformations early pregnancy population based cohort retrospective exposed to other treatment, sick excluded Adjustment: No Partial overlapping 1.13 [0.74;1.72] C
excluded (control group)
58/1,511   37/1,084 95 1,511
ref
S9626
R34231
Källén (Carbamazepine) (Controls unexposed, NOS) (Indications NOS), 2013 Relatively severe malformations early pregnancy population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes Partial overlapping 1.04 [0.80;1.35] 58/1,511   49,499/1,575,847 49,557 1,511
ref
S9653
R34363
Bànhidy (Carbamazepine), 2011 Total congenital abnormalities throughout pregnancy case control unexposed, sick Adjustment: No Matched 0.67 [0.19;2.33] C 8/18   12/22 20 18
ref
S9608
R34065
Charlton (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2011 Major congenital malformations 1st trimester retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: No 1.38 [0.39;4.95] C
excluded (control group)
13/311   3/98 16 311
ref
S9609
R34068
Charlton (Carbamazepine) (Controls unexposed, sick), 2011 Major congenital malformations 1st trimester retrospective cohort (claims database) unexposed, sick Adjustment: No 1.71 [0.87;3.36] 13/311   22/902 35 311
ref
S9628
R34240
Mawer (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2010 Major malformations 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No 0.55 [0.07;4.05] C
excluded (control group)
2/66   2/37 4 66
ref
S9629
R34242
Mawer (Carbamazepine) (Controls unexposed, disease free), 2010 Major malformations 1st trimester prospective cohort unexposed, disease free excluded Adjustment: No Matched 1.45 [0.23;7.37]
excluded (control group)
2/66   6/285 8 66
ref
S9630
R34244
Mawer (Carbamazepine) (Controls unexposed, sick), 2010 Major malformations 1st trimester prospective cohort unexposed, sick Adjustment: No 1.25 [0.11;14.24] C 2/66   1/41 3 66
ref
S9669
R34417
Kini (Carbamazepine) (Controls unexposed, sick), 2006 Major malformations during pregnancy (anytime or not specified) excluded retrospective cohort unexposed, sick Adjustment: No 1.36 [0.36;5.23]
excluded (exposition period)
5/94   4/101 9 94
ref
S9631
R34246
Meador (Carbamazepine), 2006 Congenital malformations during pregnancy (anytime or not specified) excluded prospective cohort exposed to other treatment, sick Adjustment: No 4.62 [0.53;40.24] C
excluded (exposition period)
5/110   1/98 6 110
ref
S9648
R34331
Viinikainen (Carbamazepine) (Controls unexposed, sick) a, 2006 Major malformations throughout pregnancy prospective cohort unexposed, sick Adjustment: No 5.26 [0.27;104.15] C 3/72   0/52 3 72
ref
S9604
R34049
Barqawi (Carbamazepine), 2005 Major congenital anomalies during pregnancy (anytime or not specified) excluded retrospective cohort unexposed, sick Adjustment: No 1.13 [0.02;60.37] C
excluded (exposition period)
0/16   0/18 0 16
ref
S9665
R34412
Kaaja (Carbamazepine), 2003 Major malformation 1st trimester prospective cohort unexposed, sick Adjustment: No 3.36 [0.73;15.46] C 10/363   2/239 12 363
ref
S9614
R34143
Dean (Carbamazepine), 2002 Major congenital malformations at least 1st trimester retrospective cohort unexposed, sick Adjustment: No 2.32 [0.47;11.54] C 8/70   2/38 10 70
ref
S9662
R34402
Diav-Citrin (Carbamazepine), 2001 Major congenital anomalies (among live born and elective termination of pregnancy) at least 1st trimester prospective cohort unexposed (general population or NOS) Adjustment: No Matched 1.98 [0.62;6.30] C 6/100   6/192 12 100
ref
S9621
R34201
Holmes (Carbamazepine) (Controls unexposed, disease free), 2001 Major malformations during pregnancy (anytime or not specified) retrospective cohort unexposed, disease free excluded Adjustment: Yes 3.00 [0.60;16.00]
excluded (control group)
3/58   9/508 12 58
ref
S9622
R34210
Holmes (Carbamazepine) (Controls unexposed, sick), 2001 Major malformations during pregnancy (anytime or not specified) excluded retrospective cohort unexposed, sick Adjustment: No 12.52 [0.63;246.98] C
excluded (exposition period)
3/58   0/98 3 58
ref
S9623
R34219
Hvas (Carbamazepine) (Controls unexposed, disease free), 2000 Major congenital malformations 1st trimester retrospective cohort unexposed, disease free excluded Adjustment: No 4.81 [1.15;20.08] C
excluded (control group)
2/37   280/23,827 282 37
ref
S9624
R34221
Hvas (Carbamazepine) (Controls unexposed, sick), 2000 Major congenital malformations 1st trimester retrospective cohort unexposed, sick Adjustment: No 15.29 [0.72;326.31] C 2/37   0/106 2 37
ref
S9657
R34386
Canger (Carbamazepine), 1999 Severe malformations 1st trimester prospective cohort unexposed, sick Adjustment: No 3.48 [0.19;63.08] C 7/113   0/25 7 113
ref
S9671
R34434
Samrén (Carbamazepine), 1999 Major congential abnormalities at least 1st trimester retrospective cohort unexposed, disease free Adjustment: No Matched 2.60 [1.40;5.00] 14/376   29/2,000 43 376
ref
S9768
R34928
Nulman (Carbamazepine) (Controls unexposed, NOS) (Mixed indications), 1997 Malformations (major) at least 1st trimester prospective cohort unexposed (general population or NOS) Adjustment: No Matched 1.03 [0.14;7.75] C 2/35   2/36 4 35
ref
S9672
R34436
Steegers-Theunissen (Carbamazepine), 1994 Major malformations (ICD9 British Paediatric Association System) during pregnancy (anytime or not specified) excluded prospective cohort unexposed, disease free Adjustment: No 2.81 [0.38;20.68] C
excluded (exposition period)
2/39   2/106 4 39
ref
S9670
R34431
Robert (Carbamazepine), 1986 Major malformations 1st trimester retrospective cohort unexposed, sick Adjustment: No 13.80 [0.22;853.65] C 0/3   0/35 0 3
ref
Total 27 studies 1.48 [1.23;1.77] 205,182 12,653
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 Cohen (Carbamazepine) (Mixed indications) (Controls unexposed, NOS), 2023Cohen, 2023 1 1.11[0.90; 1.37]148,0182,67415%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Mari (Carbamazepine), 2022Mari, 2022 2 1.15[0.04; 30.40]1290%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: unclear The NAAED (Controls unexposed, disease free) (Indications NOS), 2022The NAAED, 2022 3 2.82[1.44; 5.51]431,1225%ROB confusion: criticalROB selection: unclearROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: low Hosny (Carbamazepine) (Controls unexposed, sick), 2021Hosny, 2021 4 0.67[0.04; 11.29]2310%ROB confusion: criticalROB selection: moderateROB classification: unclearROB missing: lowROB mesure: unclearROB reporting: moderate Thomas (Carbamazepine) (Controls unexposed, sick), 2021Thomas, 2021 5 0.99[0.50; 1.80]394906%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Meador (Carbamazepine) (Controls unexposed, sick), 2020Meador, 2020 6 1.08[0.06; 19.05]2140%ROB confusion: unclearROB selection: lowROB classification: lowROB missing: lowROB mesure: moderateROB reporting: low Huber-Mollema (Carbamazepine), 2019Huber-Mollema, 2019 7 2.55[0.60; 10.78]8371%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: criticalROB mesure: moderateROB reporting: moderate Vajda (Carbamazepine) (Controls unexposed, sick), 2019Vajda, 2019 8 2.07[0.80; 5.33]294093%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Tomson (Carbamazepine), 2018Tomson, 2018 9 1.91[1.41; 2.58]1811,95712%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Ban (Carbamazepine) (Mixed indications) (Controls unexposed NOS), 2015Ban, 2015 10 1.42[0.68; 2.93]6,9353435%ROB confusion: seriousROB selection: moderateROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Vanya (Carbamazepine) (Controls unexposed, sick), 2015Vanya, 2015 11 6.88[0.25; 186.69]1100%ROB confusion: criticalROB selection: criticalROB classification: unclearROB missing: unclearROB mesure: unclearROB reporting: moderate Campbell (Carbamazepine) (Controls unexposed, sick), 2014Campbell, 2014 12 1.08[0.58; 2.03]561,6576%ROB confusion: unclearROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Veiby (Carbamazepine) (Controls unexposed, sick) (Mixed indications), 2014Veiby, 2014 13 1.04[0.64; 1.69]1266858%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: moderateROB mesure: moderateROB reporting: moderate Cassina (Carbamazepine) (Controls unexposed, disease free) (Mixed indications), 2013Cassina, 2013 14 2.22[0.98; 5.05]331204%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Källén (Carbamazepine) (Controls unexposed, NOS) (Indications NOS), 2013Källén, 2013 15 1.04[0.80; 1.35]49,5571,51114%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Bànhidy (Carbamazepine), 2011Bànhidy, 2011 16 0.67[0.19; 2.33]20182%ROB confusion: criticalROB selection: criticalROB classification: lowROB missing: lowROB mesure: moderateROB reporting: moderate Charlton (Carbamazepine) (Controls unexposed, sick), 2011Charlton, 2011 17 1.71[0.87; 3.36]353115%ROB confusion: criticalROB selection: moderateROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Mawer (Carbamazepine) (Controls unexposed, sick), 2010Mawer, 2010 18 1.25[0.11; 14.24]3661%ROB confusion: criticalROB selection: moderateROB classification: lowROB missing: moderateROB mesure: moderateROB reporting: moderate Viinikainen (Carbamazepine) (Controls unexposed, sick) a, 2006Viinikainen, 2006 19 5.26[0.27; 104.15]3720%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Kaaja (Carbamazepine), 2003Kaaja, 2003 20 3.36[0.73; 15.46]123631%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Dean (Carbamazepine), 2002Dean, 2002 21 2.32[0.47; 11.54]10701%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Diav-Citrin (Carbamazepine), 2001Diav-Citrin, 2001 22 1.98[0.62; 6.30]121002%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Hvas (Carbamazepine) (Controls unexposed, sick), 2000Hvas, 2000 23 15.29[0.72; 326.31]2370%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Canger (Carbamazepine), 1999Canger, 1999 24 3.48[0.19; 63.08]71130%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Samrén (Carbamazepine), 1999Samrén, 1999 25 2.60[1.40; 5.00]433766%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Nulman (Carbamazepine) (Controls unexposed, NOS) (Mixed indications), 1997Nulman, 1997 26 1.03[0.14; 7.75]4351%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Robert (Carbamazepine), 1986Robert, 1986 27 13.80[0.22; 853.65]030%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (27 studies) I2 = 28% 1.48[1.23; 1.77]205,18212,6530.250.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Carbamazepine) (Mixed indications) (Controls unexposed, NOS; 2: Carbamazepine; 3: Controls unexposed, disease free) (Indications NOS; 4: Carbamazepine) (Controls unexposed, sick; 5: Carbamazepine) (Controls unexposed, sick; 6: Carbamazepine) (Controls unexposed, sick; 7: Carbamazepine; 8: Carbamazepine) (Controls unexposed, sick; 9: Carbamazepine; 10: Carbamazepine) (Mixed indications) (Controls unexposed NOS; 11: Carbamazepine) (Controls unexposed, sick; 12: Carbamazepine) (Controls unexposed, sick; 13: Carbamazepine) (Controls unexposed, sick) (Mixed indications; 14: Carbamazepine) (Controls unexposed, disease free) (Mixed indications; 15: Carbamazepine) (Controls unexposed, NOS) (Indications NOS; 16: Carbamazepine; 17: Carbamazepine) (Controls unexposed, sick; 18: Carbamazepine) (Controls unexposed, sick; 19: Carbamazepine) (Controls unexposed, sick) ; 20: Carbamazepine; 21: Carbamazepine; 22: Carbamazepine; 23: Carbamazepine) (Controls unexposed, sick; 24: Carbamazepine; 25: Carbamazepine; 26: Carbamazepine) (Controls unexposed, NOS) (Mixed indications; 27: Carbamazepine;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.50[1.25; 1.80]205,16212,63529%NACohen (Carbamazepine) (Mixed indications) (Controls unexposed, NOS), 2023 Mari (Carbamazepine), 2022 The NAAED (Controls unexposed, disease free) (Indications NOS), 2022 Hosny (Carbamazepine) (Controls unexposed, sick), 2021 Thomas (Carbamazepine) (Controls unexposed, sick), 2021 Meador (Carbamazepine) (Controls unexposed, sick), 2020 Huber-Mollema (Carbamazepine), 2019 Vajda (Carbamazepine) (Controls unexposed, sick), 2019 Tomson (Carbamazepine), 2018 Ban (Carbamazepine) (Mixed indications) (Controls unexposed NOS), 2015 Vanya (Carbamazepine) (Controls unexposed, sick), 2015 Campbell (Carbamazepine) (Controls unexposed, sick), 2014 Veiby (Carbamazepine) (Controls unexposed, sick) (Mixed indications), 2014 Cassina (Carbamazepine) (Controls unexposed, disease free) (Mixed indications), 2013 Källén (Carbamazepine) (Controls unexposed, NOS) (Indications NOS), 2013 Charlton (Carbamazepine) (Controls unexposed, sick), 2011 Mawer (Carbamazepine) (Controls unexposed, sick), 2010 Viinikainen (Carbamazepine) (Controls unexposed, sick) a, 2006 Kaaja (Carbamazepine), 2003 Dean (Carbamazepine), 2002 Diav-Citrin (Carbamazepine), 2001 Hvas (Carbamazepine) (Controls unexposed, sick), 2000 Canger (Carbamazepine), 1999 Samrén (Carbamazepine), 1999 Nulman (Carbamazepine) (Controls unexposed, NOS) (Mixed indications), 1997 Robert (Carbamazepine), 1986 26 case control studiescase control studies 0.67[0.19; 2.33]2018 -NABànhidy (Carbamazepine), 2011 1 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.53[1.13; 2.06]204,6456,28157%NACohen (Carbamazepine) (Mixed indications) (Controls unexposed, NOS), 2023 The NAAED (Controls unexposed, disease free) (Indications NOS), 2022 Ban (Carbamazepine) (Mixed indications) (Controls unexposed NOS), 2015 Cassina (Carbamazepine) (Controls unexposed, disease free) (Mixed indications), 2013 Källén (Carbamazepine) (Controls unexposed, NOS) (Indications NOS), 2013 Diav-Citrin (Carbamazepine), 2001 Samrén (Carbamazepine), 1999 Nulman (Carbamazepine) (Controls unexposed, NOS) (Mixed indications), 1997 8 unexposed, sickunexposed, sick 1.30[1.00; 1.68]3474,3490%NAHosny (Carbamazepine) (Controls unexposed, sick), 2021 Thomas (Carbamazepine) (Controls unexposed, sick), 2021 Meador (Carbamazepine) (Controls unexposed, sick), 2020 Vajda (Carbamazepine) (Controls unexposed, sick), 2019 Vanya (Carbamazepine) (Controls unexposed, sick), 2015 Campbell (Carbamazepine) (Controls unexposed, sick), 2014 Veiby (Carbamazepine) (Controls unexposed, sick) (Mixed indications), 2014 Bànhidy (Carbamazepine), 2011 Charlton (Carbamazepine) (Controls unexposed, sick), 2011 Mawer (Carbamazepine) (Controls unexposed, sick), 2010 Viinikainen (Carbamazepine) (Controls unexposed, sick) a, 2006 Kaaja (Carbamazepine), 2003 Dean (Carbamazepine), 2002 Hvas (Carbamazepine) (Controls unexposed, sick), 2000 Canger (Carbamazepine), 1999 Robert (Carbamazepine), 1986 16 exposed to other treatment, sickexposed to other treatment, sick 1.92[1.43; 2.58]1902,0230%NAMari (Carbamazepine), 2022 Huber-Mollema (Carbamazepine), 2019 Tomson (Carbamazepine), 2018 3 Tags Adjustment   - No  - No 1.63[1.32; 2.01]148,65110,30924%NACohen (Carbamazepine) (Mixed indications) (Controls unexposed, NOS), 2023 Mari (Carbamazepine), 2022 The NAAED (Controls unexposed, disease free) (Indications NOS), 2022 Hosny (Carbamazepine) (Controls unexposed, sick), 2021 Meador (Carbamazepine) (Controls unexposed, sick), 2020 Huber-Mollema (Carbamazepine), 2019 Vajda (Carbamazepine) (Controls unexposed, sick), 2019 Tomson (Carbamazepine), 2018 Vanya (Carbamazepine) (Controls unexposed, sick), 2015 Campbell (Carbamazepine) (Controls unexposed, sick), 2014 Veiby (Carbamazepine) (Controls unexposed, sick) (Mixed indications), 2014 Cassina (Carbamazepine) (Controls unexposed, disease free) (Mixed indications), 2013 Bànhidy (Carbamazepine), 2011 Charlton (Carbamazepine) (Controls unexposed, sick), 2011 Mawer (Carbamazepine) (Controls unexposed, sick), 2010 Viinikainen (Carbamazepine) (Controls unexposed, sick) a, 2006 Kaaja (Carbamazepine), 2003 Dean (Carbamazepine), 2002 Diav-Citrin (Carbamazepine), 2001 Hvas (Carbamazepine) (Controls unexposed, sick), 2000 Canger (Carbamazepine), 1999 Samrén (Carbamazepine), 1999 Nulman (Carbamazepine) (Controls unexposed, NOS) (Mixed indications), 1997 Robert (Carbamazepine), 1986 24   - Yes  - Yes 1.07[0.85; 1.34]56,5312,3440%NAThomas (Carbamazepine) (Controls unexposed, sick), 2021 Ban (Carbamazepine) (Mixed indications) (Controls unexposed NOS), 2015 Källén (Carbamazepine) (Controls unexposed, NOS) (Indications NOS), 2013 3 Controls   - epilepsy indication  - epilepsy indication 1.04[0.64; 1.69]126685 -NAVeiby (Carbamazepine) (Controls unexposed, sick) (Mixed indications), 2014 1 MatchedMatched 1.71[0.91; 3.22]7952925%NABànhidy (Carbamazepine), 2011 Diav-Citrin (Carbamazepine), 2001 Samrén (Carbamazepine), 1999 Nulman (Carbamazepine) (Controls unexposed, NOS) (Mixed indications), 1997 4 Partial overlappingPartial overlapping 1.08[0.92; 1.26]197,7014,8700%NACohen (Carbamazepine) (Mixed indications) (Controls unexposed, NOS), 2023 Veiby (Carbamazepine) (Controls unexposed, sick) (Mixed indications), 2014 Källén (Carbamazepine) (Controls unexposed, NOS) (Indications NOS), 2013 3 All studiesAll studies 1.48[1.23; 1.77]205,18212,65328%NACohen (Carbamazepine) (Mixed indications) (Controls unexposed, NOS), 2023 Mari (Carbamazepine), 2022 The NAAED (Controls unexposed, disease free) (Indications NOS), 2022 Hosny (Carbamazepine) (Controls unexposed, sick), 2021 Thomas (Carbamazepine) (Controls unexposed, sick), 2021 Meador (Carbamazepine) (Controls unexposed, sick), 2020 Huber-Mollema (Carbamazepine), 2019 Vajda (Carbamazepine) (Controls unexposed, sick), 2019 Tomson (Carbamazepine), 2018 Ban (Carbamazepine) (Mixed indications) (Controls unexposed NOS), 2015 Vanya (Carbamazepine) (Controls unexposed, sick), 2015 Campbell (Carbamazepine) (Controls unexposed, sick), 2014 Veiby (Carbamazepine) (Controls unexposed, sick) (Mixed indications), 2014 Cassina (Carbamazepine) (Controls unexposed, disease free) (Mixed indications), 2013 Källén (Carbamazepine) (Controls unexposed, NOS) (Indications NOS), 2013 Bànhidy (Carbamazepine), 2011 Charlton (Carbamazepine) (Controls unexposed, sick), 2011 Mawer (Carbamazepine) (Controls unexposed, sick), 2010 Viinikainen (Carbamazepine) (Controls unexposed, sick) a, 2006 Kaaja (Carbamazepine), 2003 Dean (Carbamazepine), 2002 Diav-Citrin (Carbamazepine), 2001 Hvas (Carbamazepine) (Controls unexposed, sick), 2000 Canger (Carbamazepine), 1999 Samrén (Carbamazepine), 1999 Nulman (Carbamazepine) (Controls unexposed, NOS) (Mixed indications), 1997 Robert (Carbamazepine), 1986 270.250.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-4.95.32.5250.000Cohen (Carbamazepine) (Mixed indications) (Controls unexposed, NOS), 2023Mari (Carbamazepine), 2022The NAAED (Controls unexposed, disease free) (Indications NOS), 2022Hosny (Carbamazepine) (Controls unexposed, sick), 2021Thomas (Carbamazepine) (Controls unexposed, sick), 2021Meador (Carbamazepine) (Controls unexposed, sick), 2020Huber-Mollema (Carbamazepine), 2019Vajda (Carbamazepine) (Controls unexposed, sick), 2019Tomson (Carbamazepine), 2018Ban (Carbamazepine) (Mixed indications) (Controls unexposed NOS), 2015Vanya (Carbamazepine) (Controls unexposed, sick), 2015Campbell (Carbamazepine) (Controls unexposed, sick), 2014Veiby (Carbamazepine) (Controls unexposed, sick) (Mixed indications), 2014Cassina (Carbamazepine) (Controls unexposed, disease free) (Mixed indications), 2013Källén (Carbamazepine) (Controls unexposed, NOS) (Indications NOS), 2013Bànhidy (Carbamazepine), 2011Charlton (Carbamazepine) (Controls unexposed, sick), 2011Mawer (Carbamazepine) (Controls unexposed, sick), 2010Viinikainen (Carbamazepine) (Controls unexposed, sick) a, 2006Kaaja (Carbamazepine), 2003Dean (Carbamazepine), 2002Diav-Citrin (Carbamazepine), 2001Hvas (Carbamazepine) (Controls unexposed, sick), 2000Canger (Carbamazepine), 1999Samrén (Carbamazepine), 1999Nulman (Carbamazepine) (Controls unexposed, NOS) (Mixed indications), 1997Robert (Carbamazepine), 1986

Asymetry test p-value = 0.0000 (by Egger's regression)

slope=0.1210 (0.0945); intercept=0.7606 (0.3039); t=2.5029; p=0.0000

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 9623, 9621, 9628, 9629, 9608, 9658, 9625, 9655, 9643, 9645, 9763, 9681, 9679, 9595, 9632, 9633, 12683, 12903, 12856, 12857, 10225, 15367, 15199, 15852

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.49[1.17; 1.89]227,3617,47245%NACohen (Carbamazepine) (Mixed indications) (Controls unexposed, NOS), 2023 The NAAED (Controls unexposed, disease free) (Indications NOS), 2022 Thomas (Carbamazepine) (Controls unexposed, disease free), 2021 Meador (Carbamazepine) (Controls unexposed, disease free), 2020 Ban (Carbamazepine) (Mixed indications) (Controls unexposed NOS), 2015 Veiby (Carbamazepine) (Controls unexposed, disease free) (Mixed indications), 2014 Cassina (Carbamazepine) (Controls unexposed, disease free) (Mixed indications), 2013 Källén (Carbamazepine) (Controls unexposed, NOS) (Indications NOS), 2013 Mawer (Carbamazepine) (Controls unexposed, disease free), 2010 Diav-Citrin (Carbamazepine), 2001 Hvas (Carbamazepine) (Controls unexposed, disease free), 2000 Samrén (Carbamazepine), 1999 Nulman (Carbamazepine) (Controls unexposed, NOS) (Mixed indications), 1997 13 unexposed, sick controlsunexposed, sick controls 1.30[1.00; 1.68]3474,3490%NAHosny (Carbamazepine) (Controls unexposed, sick), 2021 Thomas (Carbamazepine) (Controls unexposed, sick), 2021 Meador (Carbamazepine) (Controls unexposed, sick), 2020 Vajda (Carbamazepine) (Controls unexposed, sick), 2019 Vanya (Carbamazepine) (Controls unexposed, sick), 2015 Campbell (Carbamazepine) (Controls unexposed, sick), 2014 Veiby (Carbamazepine) (Controls unexposed, sick) (Mixed indications), 2014 Bànhidy (Carbamazepine), 2011 Charlton (Carbamazepine) (Controls unexposed, sick), 2011 Mawer (Carbamazepine) (Controls unexposed, sick), 2010 Viinikainen (Carbamazepine) (Controls unexposed, sick) a, 2006 Kaaja (Carbamazepine), 2003 Dean (Carbamazepine), 2002 Hvas (Carbamazepine) (Controls unexposed, sick), 2000 Canger (Carbamazepine), 1999 Robert (Carbamazepine), 1986 16 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.21[0.98; 1.48]1,03311,46631%NACohen (Carbamazepine) (Mixed indications) (Controls exposed to LTG), 2023 Mari (Carbamazepine), 2022 The NAAED (Controls exposed to Lamotrigine, sick) (Indications NOS), 2022 Hosny (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2021 Thomas (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2021 Meador (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2020 Huber-Mollema (Carbamazepine), 2019 Vajda (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2019 Tomson (Carbamazepine), 2018 Ban (Carbamazepine) (Mixed indications) (Controls exposed to Lamotrigine, sick), 2015 Vanya (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2015 Campbell (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2014 Veiby (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2014 Cassina (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2013 Källén (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Indications NOS), 2013 Charlton (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2011 Mawer (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2010 170.510.01.0