Reply to Journal Club Roundtable

Abstract

We write this letter in response to the Journal Club Roundtable discussion1 on our article, “Use of topiramate in pregnancy and risk of oral clefts.”2 We agree with the noted limitations and welcome the opportunity to briefly discuss recall and recall bias in the setting of our study.

Incomplete recall among the mothers of control infants, as discussed in the journal club, is always a concern in studies where exposure information is self-reported after the pregnancy outcome is known. During the period of data collection for our study, there was no information available to the public relating topiramate to oral clefts or other congenital malformations. Therefore, recall bias, if present, should have affected analyses on all malformations, inflating the estimated relative risks. The odds ratio of 1 for topiramate and major congenital malformations in the pooled data argues strongly against recall bias in the present study.