Carbamazepine (All indications)

Preterm (< 37 weeks)

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
R63234
Bromley (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2023 Preterm birth (gestational age < 37 weeks) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No 0.76 [0.20;2.84] C
excluded (control group)
3/27   15/106 18 27
ref
S15368
R63247
Bromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Preterm birth (gestational age < 37 weeks) during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No 0.78 [0.20;3.05] C 3/27   11/80 14 27
ref
S9602
R34028
Aydin (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2020 Preterm delivery (before 37 weeks of gestation) throughout pregnancy retrospective cohort exposed to other treatment, sick excluded Adjustment: No 2.60 [0.11;62.58] C
excluded (control group)
2/15   0/7 2 15
ref
S9603
R34038
Aydin (Carbamazepine) (Controls unexposed, sick), 2020 Preterm delivery (before 37 weeks of gestation) throughout pregnancy retrospective cohort unexposed, sick Adjustment: No 1.54 [0.19;12.32] C 2/15   2/22 4 15
ref
S9776
R34957
Coste (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2020 Gestational age at birth (< 37 WA) during pregnancy (anytime or not specified) retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: No 0.79 [0.51;1.21] C
excluded (control group)
25/502   182/2,916 207 502
ref
S9777
R34975
Coste (Carbamazepine) (Controls unexposed, NOS) (Mixed indications), 2020 Gestational age at birth (< 37 WA) during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No 0.88 [0.57;1.34] C 22/468   90,991/1,707,707 91,013 468
ref
S9761
R34853
Cohen (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2019 Preterm birth (ICD-9 644.2, 774.2, 776.6, 362.20, 362.22, 362.27, 765 excluding 765.20, 765.29) early pregnancy retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: Yes 1.16 [0.88;1.52]
excluded (control group)
186/1,232   392/2,682 578 1,232
ref
S9762
R34860
Cohen (Carbamazepine) (Controls unexposed NOS) (Mixed indications), 2019 Preterm birth (ICD-9 644.2, 774.2, 776.6, 362.20, 362.22, 362.27, 765 excluding 765.20, 765.29) early pregnancy retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: Yes 0.90 [0.75;1.09] 186/1,232   160,604/1,440,631 160,790 1,232
ref
S9760
R34842
Bank (Carbamazepine) (Mixed indications), 2017 Premature (<37 weeks gestation) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick Adjustment: No 11.67 [0.91;149.71] C 2/8   1/36 3 8
ref
S9597
R33985
Arkilo (Carbamazepine), 2015 Premature delivery during pregnancy (anytime or not specified) retrospective cohort exposed to other treatment, sick Adjustment: No 3.52 [0.68;18.07] C 5/14   3/22 8 14
ref
S9772
R34945
Kilic (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2014 Preterm (< 37 weeks) during pregnancy (anytime or not specified) population based cohort retrospective exposed to other treatment, sick excluded Adjustment: No 0.84 [0.54;1.32] C
excluded (control group)
28/347   83/880 111 347
ref
S9773
R34948
Kilic (Carbamazepine) (Controls unexposed NOS) (Mixed indications), 2014 Preterm (< 37 weeks) during pregnancy (anytime or not specified) population based cohort retrospective unexposed (general population or NOS) excluded Adjustment: Yes 1.60 [1.00;2.30]
excluded (control group)
28/347   33,974/676,834 34,002 347
ref
S9774
R34951
Kilic (Carbamazepine) (Controls unexposed, sick) (Mixed indications), 2014 Preterm (< 37 weeks) during pregnancy (anytime or not specified) population based cohort retrospective unexposed, sick Adjustment: No Controls: epilepsy indication 1.13 [0.75;1.68] C 28/347   383/5,296 411 347
ref
S9598
R33998
Artama (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013 Preterm birth (<37 gestational weeks) during pregnancy (anytime or not specified) population based cohort retrospective exposed to other treatment, sick excluded Adjustment: No 1.17 [0.55;2.50] C
excluded (control group)
58/1,077   8/173 66 1,077
ref
S9599
R34010
Artama (Carbamazepine) (Controls unexposed, disease free), 2013 Preterm birth (<37 gestational weeks) during pregnancy (anytime or not specified) population based cohort retrospective unexposed, disease free excluded Adjustment: Yes 1.32 [1.01;1.72]
excluded (control group)
58/1,077   30,027/719,509 30,085 1,077
ref
S9600
R34022
Artama (Carbamazepine) (Controls unexposed, sick), 2013 Preterm birth (<37 gestational weeks) during pregnancy (anytime or not specified) population based cohort retrospective unexposed, sick Adjustment: Yes 1.13 [0.80;1.60] 58/1,077   85/1,793 143 1,077
ref
S9743
R34760
Veiby (Carbamazepine) (Controls exposed to Lamotrigine, sick) b, 2013 Preterm delivery (< 37 weeks) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No 0.87 [0.24;3.10] C
excluded (control group)
4/67   7/103 11 67
ref
S9745
R34779
Veiby (Carbamazepine) (Controls unexposed, disease free) b, 2013 Preterm delivery (< 37 weeks) during pregnancy (anytime or not specified) prospective cohort unexposed, disease free excluded Adjustment: No 0.80 [0.30;2.30]
excluded (control group)
4/67   7,269/106,899 7,273 67
ref
S9746
R34793
Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013 Preterm delivery (< 37 weeks) during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No 0.75 [0.26;2.21] C 4/67   30/386 34 67
ref
S9640
R34293
Pennell (Carbamazepine), 2012 Preterm Birth (< 37 weeks GA) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick Adjustment: No 1.85 [0.64;5.30] C 10/93   6/98 16 93
ref
S9712
R34568
Cummings (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2011 Preterm (35-37 weeks) throughout pregnancy retrospective cohort (registry) exposed to other treatment, sick excluded Adjustment: No 0.53 [0.13;2.15] C
excluded (control group)
4/49   5/35 9 49
ref
S9713
R34571
Cummings (Carbamazepine) (Controls unexposed, disease free), 2011 Preterm (35-37 weeks) throughout pregnancy retrospective cohort (registry) unexposed, disease free Adjustment: No 8.80 [0.46;168.35] C 4/49   0/44 4 49
ref
S9733
R34663
Nadebaum (Carbamazepine), 2011 Born premature (<37 wk) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick Adjustment: No 0.78 [0.03;21.03] C 1/34   0/9 1 34
ref
S9729
R34644
McVearry (Carbamazepine), 2009 Premature birth during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick Adjustment: No 6.11 [0.27;138.46] C 2/16   0/17 2 16
ref
S9615
R34169
Endo (Carbamazepine) (Controls unexposed, disease free), 2004 Preterm delivery (< week 37) throughout pregnancy retrospective cohort unexposed, disease free excluded Adjustment: No 2.12 [0.41;11.09] C
excluded (control group)
2/7   104/656 106 7
ref
S9616
R34184
Endo (Carbamazepine) (Controls unexposed, sick), 2004 Preterm delivery (< week 37) throughout pregnancy retrospective cohort unexposed, sick Adjustment: No 0.56 [0.01;37.57] C 2/7   0/1 2 7
ref
S9662
R34401
Diav-Citrin (Carbamazepine), 2001 Premature infants (week < 37) at least 1st trimester prospective cohort unexposed (general population or NOS) Adjustment: No Matched 2.41 [0.90;6.48] C 9/91   8/184 17 91
ref
S9740
R34706
Van der Pol (Carbamazepine) (Controls unexposed, disease free), 1991 Gestational age (≤ 37 wk) throughout pregnancy prospective cohort unexposed, disease free excluded Adjustment: No Matched 0.53 [0.03;10.70] C
excluded (control group)
0/11   4/55 4 11
ref
S9741
R34731
Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 Gestational age (≤ 37 wk) throughout pregnancy prospective cohort unexposed, sick Adjustment: No 0.37 [0.02;8.48] C 0/11   2/22 2 11
ref
Total 16 studies 1.06 [0.88;1.27] 252,464 3,556
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 0.78[0.20; 3.05]14272%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]4151%ROB confusion: criticalROB selection: criticalROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Coste (Carbamazepine) (Controls unexposed, NOS) (Mixed indications), 2020Coste, 2020 3 0.88[0.57; 1.34]91,01346814%ROB confusion: criticalROB selection: moderateROB classification: criticalROB missing: moderateROB mesure: moderateROB reporting: moderate Cohen (Carbamazepine) (Controls unexposed NOS) (Mixed indications), 2019Cohen, 2019 4 0.90[0.75; 1.09]160,7901,23237%ROB confusion: moderateROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Bank (Carbamazepine) (Mixed indications), 2017Bank, 2017 5 11.67[0.91; 149.71]381%ROB confusion: criticalROB selection: lowROB classification: lowROB missing: lowROB mesure: moderateROB reporting: moderate Arkilo (Carbamazepine), 2015Arkilo, 2015 6 3.52[0.68; 18.07]8141%ROB confusion: criticalROB selection: criticalROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Kilic (Carbamazepine) (Controls unexposed, sick) (Mixed indications), 2014Kilic, 2014 7 1.13[0.75; 1.68]41134716%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Artama (Carbamazepine) (Controls unexposed, sick), 2013Artama, 2013 8 1.13[0.80; 1.60]1431,07719%ROB confusion: moderateROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013Veiby, 2013 9 0.75[0.26; 2.21]34673%ROB confusion: criticalROB selection: lowROB classification: lowROB missing: moderateROB mesure: moderateROB reporting: moderate Pennell (Carbamazepine), 2012Pennell, 2012 10 1.85[0.64; 5.30]16933%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Cummings (Carbamazepine) (Controls unexposed, disease free), 2011Cummings, 2011 11 8.80[0.46; 168.35]4490%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: unclearROB mesure: lowROB reporting: moderate Nadebaum (Carbamazepine), 2011Nadebaum, 2011 12 0.78[0.03; 21.03]1340%ROB confusion: criticalROB selection: lowROB classification: lowROB missing: criticalROB mesure: lowROB reporting: moderate McVearry (Carbamazepine), 2009McVearry, 2009 13 6.11[0.27; 138.46]2160%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Endo (Carbamazepine) (Controls unexposed, sick), 2004Endo, 2004 14 0.56[0.01; 37.57]270%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Diav-Citrin (Carbamazepine), 2001Diav-Citrin, 2001 15 2.41[0.90; 6.48]17913%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991Van der Pol, 1991 16 0.37[0.02; 8.48]2110%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Total (16 studies) I2 = 12% 1.06[0.88; 1.27]252,4643,5560.250.01.0ROB: 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) (Controls unexposed, NOS) (Mixed indications; 4: Carbamazepine) (Controls unexposed NOS) (Mixed indications; 5: Carbamazepine) (Mixed indications; 6: Carbamazepine; 7: Carbamazepine) (Controls unexposed, sick) (Mixed indications; 8: Carbamazepine) (Controls unexposed, sick; 9: Carbamazepine) (Controls unexposed, sick) ; 10: Carbamazepine; 11: Carbamazepine) (Controls unexposed, disease free; 12: Carbamazepine; 13: Carbamazepine; 14: Carbamazepine) (Controls unexposed, sick; 15: Carbamazepine; 16: Carbamazepine) (Controls unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.06[0.88; 1.27]252,4643,55612%NABromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Aydin (Carbamazepine) (Controls unexposed, sick), 2020 Coste (Carbamazepine) (Controls unexposed, NOS) (Mixed indications), 2020 Cohen (Carbamazepine) (Controls unexposed NOS) (Mixed indications), 2019 Bank (Carbamazepine) (Mixed indications), 2017 Arkilo (Carbamazepine), 2015 Kilic (Carbamazepine) (Controls unexposed, sick) (Mixed indications), 2014 Artama (Carbamazepine) (Controls unexposed, sick), 2013 Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013 Pennell (Carbamazepine), 2012 Cummings (Carbamazepine) (Controls unexposed, disease free), 2011 Nadebaum (Carbamazepine), 2011 McVearry (Carbamazepine), 2009 Endo (Carbamazepine) (Controls unexposed, sick), 2004 Diav-Citrin (Carbamazepine), 2001 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 16 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.05[0.71; 1.56]251,8241,84050%NACoste (Carbamazepine) (Controls unexposed, NOS) (Mixed indications), 2020 Cohen (Carbamazepine) (Controls unexposed NOS) (Mixed indications), 2019 Cummings (Carbamazepine) (Controls unexposed, disease free), 2011 Diav-Citrin (Carbamazepine), 2001 4 unexposed, sickunexposed, sick 1.09[0.85; 1.39]6101,5510%NABromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Aydin (Carbamazepine) (Controls unexposed, sick), 2020 Kilic (Carbamazepine) (Controls unexposed, sick) (Mixed indications), 2014 Artama (Carbamazepine) (Controls unexposed, sick), 2013 Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013 Endo (Carbamazepine) (Controls unexposed, sick), 2004 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 7 exposed to other treatment, sickexposed to other treatment, sick 2.62[1.20; 5.75]301650%NABank (Carbamazepine) (Mixed indications), 2017 Arkilo (Carbamazepine), 2015 Pennell (Carbamazepine), 2012 Nadebaum (Carbamazepine), 2011 McVearry (Carbamazepine), 2009 5 Tags Adjustment   - No  - No 1.20[0.90; 1.60]91,5311,2477%NABromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Aydin (Carbamazepine) (Controls unexposed, sick), 2020 Coste (Carbamazepine) (Controls unexposed, NOS) (Mixed indications), 2020 Bank (Carbamazepine) (Mixed indications), 2017 Arkilo (Carbamazepine), 2015 Kilic (Carbamazepine) (Controls unexposed, sick) (Mixed indications), 2014 Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013 Pennell (Carbamazepine), 2012 Cummings (Carbamazepine) (Controls unexposed, disease free), 2011 Nadebaum (Carbamazepine), 2011 McVearry (Carbamazepine), 2009 Endo (Carbamazepine) (Controls unexposed, sick), 2004 Diav-Citrin (Carbamazepine), 2001 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 14   - Yes  - Yes 0.96[0.79; 1.18]160,9332,30922%NACohen (Carbamazepine) (Controls unexposed NOS) (Mixed indications), 2019 Artama (Carbamazepine) (Controls unexposed, sick), 2013 2 Controls   - epilepsy indication  - epilepsy indication 1.13[0.75; 1.68]411347 -NAKilic (Carbamazepine) (Controls unexposed, sick) (Mixed indications), 2014 1 MatchedMatched 2.41[0.90; 6.48]1791 -NADiav-Citrin (Carbamazepine), 2001 1 All studiesAll studies 1.06[0.88; 1.27]252,4643,55612%NABromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Aydin (Carbamazepine) (Controls unexposed, sick), 2020 Coste (Carbamazepine) (Controls unexposed, NOS) (Mixed indications), 2020 Cohen (Carbamazepine) (Controls unexposed NOS) (Mixed indications), 2019 Bank (Carbamazepine) (Mixed indications), 2017 Arkilo (Carbamazepine), 2015 Kilic (Carbamazepine) (Controls unexposed, sick) (Mixed indications), 2014 Artama (Carbamazepine) (Controls unexposed, sick), 2013 Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013 Pennell (Carbamazepine), 2012 Cummings (Carbamazepine) (Controls unexposed, disease free), 2011 Nadebaum (Carbamazepine), 2011 McVearry (Carbamazepine), 2009 Endo (Carbamazepine) (Controls unexposed, sick), 2004 Diav-Citrin (Carbamazepine), 2001 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 160.150.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-5.15.12.5800.000Bromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023Aydin (Carbamazepine) (Controls unexposed, sick), 2020Coste (Carbamazepine) (Controls unexposed, NOS) (Mixed indications), 2020Cohen (Carbamazepine) (Controls unexposed NOS) (Mixed indications), 2019Bank (Carbamazepine) (Mixed indications), 2017Arkilo (Carbamazepine), 2015Kilic (Carbamazepine) (Controls unexposed, sick) (Mixed indications), 2014Artama (Carbamazepine) (Controls unexposed, sick), 2013Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013Pennell (Carbamazepine), 2012Cummings (Carbamazepine) (Controls unexposed, disease free), 2011Nadebaum (Carbamazepine), 2011McVearry (Carbamazepine), 2009Endo (Carbamazepine) (Controls unexposed, sick), 2004Diav-Citrin (Carbamazepine), 2001Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991

Asymetry test p-value = 0.0273 (by Egger's regression)

slope=-0.1390 (0.0873); intercept=0.7686 (0.3119); t=2.4645; p=0.0273

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 9740, 9615, 9712, 9598, 9599, 9743, 9745, 9772, 9773, 9761, 9602, 9776, 15367

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.18[0.91; 1.52]323,2943,34950%NACoste (Carbamazepine) (Controls unexposed, NOS) (Mixed indications), 2020 Cohen (Carbamazepine) (Controls unexposed NOS) (Mixed indications), 2019 Kilic (Carbamazepine) (Controls unexposed NOS) (Mixed indications), 2014 Artama (Carbamazepine) (Controls unexposed, disease free), 2013 Veiby (Carbamazepine) (Controls unexposed, disease free) b, 2013 Cummings (Carbamazepine) (Controls unexposed, disease free), 2011 Endo (Carbamazepine) (Controls unexposed, disease free), 2004 Diav-Citrin (Carbamazepine), 2001 Van der Pol (Carbamazepine) (Controls unexposed, disease free), 1991 9 unexposed, sick controlsunexposed, sick controls 1.09[0.85; 1.39]6101,5510%NABromley (Carbamazepine) (Epilepsy) (Controls unexposed, sick), 2023 Aydin (Carbamazepine) (Controls unexposed, sick), 2020 Kilic (Carbamazepine) (Controls unexposed, sick) (Mixed indications), 2014 Artama (Carbamazepine) (Controls unexposed, sick), 2013 Veiby (Carbamazepine) (Controls unexposed, sick) b, 2013 Endo (Carbamazepine) (Controls unexposed, sick), 2004 Van der Pol (Carbamazepine) (Controls unexposed, sick), 1991 7 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.04[0.84; 1.28]1,0323,4815%NABromley (Carbamazepine) (Epilepsy) (Controls exposed to LTG), 2023 Aydin (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2020 Coste (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2020 Cohen (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2019 Bank (Carbamazepine) (Mixed indications), 2017 Arkilo (Carbamazepine), 2015 Kilic (Carbamazepine) (Controls exposed to Lamotrigine, sick) (Mixed indications), 2014 Artama (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2013 Veiby (Carbamazepine) (Controls exposed to Lamotrigine, sick) b, 2013 Pennell (Carbamazepine), 2012 Cummings (Carbamazepine) (Controls exposed to Lamotrigine, sick), 2011 Nadebaum (Carbamazepine), 2011 McVearry (Carbamazepine), 2009 130.510.01.0