Paternal exposure to antiseizure medications and offspring outcomes: a systematic review and meta-analysis of observational studies
Bibliographic record
Abstract
To assess the risk of adverse offspring outcomes related to paternal antiseizure treatment during conception. We identified studies of offspring outcomes for fathers with vs. without antiseizure medication(s) during conception in Embase/Medline in 01/2025. Study quality was evaluated using the Newcastle-Ottawa-Scale. Our primary outcome was the odds ratio (OR, 95% confidence intervals [95%CI]) of offspring outcomes in fathers with vs. without antiseizure medication(s). A subgroup analysis assessing the study design impact and sensitivity analyses after excluding poor-quality studies, and sequentially each study, were performed. Of the six studies included (k = 6, n = 17,974), two and four were rated as good- and poor-quality studies, respectively. There were no differences regarding risk of major congenital malformations in offsprings with vs. without paternal antiseizure medication(s) (OR = 1.22, 95%CI = 0.55 to 2.68, p = 0.63), with substantial heterogeneity (I2 = 93.0%). In six studies (k = 6, n = 17,604) there were no differences regarding risk of neurodevelopmental disorders in offsprings with vs. without paternal antiseizure medication(s) (OR = 1.21, 95%CI = 0.73 to 1.99, p = 0.46, I2 = 95.6%); ORs of paternal antiseizure medication-related neurodevelopmental disorders were higher in cross-sectional (n = 3) vs. cohort studies (n = 3) (p < 0.001). There is no evidence of elevated risk of adverse outcomes for offsprings with vs. without paternal antiseizure treatment, although heterogeneity was substantial. www.crd.york.ac.uk/prospero identifier is CRD42025635478.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.015 | 0.042 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.014 | 0.028 |
| Bibliometrics | 0.008 | 0.010 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".