Beta-blockers (All routes except ocular) (versus unexposed) updated on 12-17-2024

Assisted deliveries (forceps, vacuum, ...)

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.
S17127
R71744
Delteil - Beta-blockers, 2024 Instrumental vaginal delivery during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No Indications Antihypertensive: All hypertensions, any indications or not specified 0.76 [0.62;0.92] C 118/910   15,243/92,608 15,361 910
ref
S17235
R72134
Kubota - Beta-blockers, 2023 Vacuum or forceps during pregnancy (anytime or not specified) retrospective cohort unexposed, sick Adjustment: No Indications Antihypertensive: Only cardiac indications other than hypertension (long QT syndrome, structural heart disease, ...) 4.28 [0.47;39.02] C 1/11   6/263 7 11
ref
S13863
R54232
Mazkereth - Beta-blockers, 2019 Instrumental delivery during pregnancy (anytime or not specified) retrospective cohort unexposed, sick Adjustment: No Indications Antihypertensive: All hypertensions, any indications or not specified Matched 1.46 [0.54;3.94] C 10/153   7/153 17 153
ref
S13902
R54406
Duan - Beta-blockers, 2018 Vaginal‐assisted delivery during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No Indications Antihypertensive: All hypertensions, any indications or not specified 0.85 [0.69;1.05] C 91/4,847   8,233/374,391 8,324 4,847
ref
S13846
R54255
Darcie - Atenolol, 2004 Forceps late pregnancy prospective cohort unexposed, sick Adjustment: No Indications Antihypertensive: All hypertensions, any indications or not specified 0.67 [0.11;4.11] C 4/40   2/14 6 40
ref
Total 5 studies 0.82 [0.70;0.95] 23,715 5,961
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 Delteil - Beta-blockers, 2024Delteil - Beta-blockers, 2024 0.76[0.62; 0.92]15,36191051%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Kubota - Beta-blockers, 2023Kubota - Beta-blockers, 2023 4.28[0.47; 39.02]7110%ROB confusion: criticalROB selection: unclearROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: critical Mazkereth - Beta-blockers, 2019Mazkereth - Beta-blockers, 2019 1.46[0.54; 3.94]171532%ROB confusion: criticalROB selection: criticalROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Duan - Beta-blockers, 2018Duan - Beta-blockers, 2018 0.85[0.69; 1.05]8,3244,84745%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Darcie - Atenolol, 2004Darcie - Atenolol, 2004 0.67[0.11; 4.11]6401%ROB confusion: seriousROB selection: criticalROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Total (5 studies) I2 = 6% 0.82[0.70; 0.95]23,7155,9610.210.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 0.82[0.70; 0.95]23,7155,9616%NADelteil - Beta-blockers, 2024 Kubota - Beta-blockers, 2023 Mazkereth - Beta-blockers, 2019 Duan - Beta-blockers, 2018 Darcie - Atenolol, 2004 5 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 0.80[0.69; 0.92]23,6855,7570%NADelteil - Beta-blockers, 2024 Duan - Beta-blockers, 2018 2 unexposed, sickunexposed, sick 1.44[0.64; 3.25]302040%NAKubota - Beta-blockers, 2023 Mazkereth - Beta-blockers, 2019 Darcie - Atenolol, 2004 3 Tags Adjustment   - No  - No 0.82[0.70; 0.95]23,7155,9616%NADelteil - Beta-blockers, 2024 Kubota - Beta-blockers, 2023 Mazkereth - Beta-blockers, 2019 Duan - Beta-blockers, 2018 Darcie - Atenolol, 2004 5 Indications Antihypertensive   - All hypertensions, any indications ...  - All hypertensions, any indications or not specified 0.81[0.70; 0.93]23,7085,9500%NADelteil - Beta-blockers, 2024 Mazkereth - Beta-blockers, 2019 Duan - Beta-blockers, 2018 Darcie - Atenolol, 2004 4   - Only cardiac indications other than ...  - Only cardiac indications other than hypertension (long QT syndrome, structural heart disease, ...) 4.28[0.47; 39.02]711 -NAKubota - Beta-blockers, 2023 1 MatchedMatched 1.46[0.54; 3.94]17153 -NAMazkereth - Beta-blockers, 2019 1 All studiesAll studies 0.82[0.70; 0.95]23,7155,9616%NADelteil - Beta-blockers, 2024 Kubota - Beta-blockers, 2023 Mazkereth - Beta-blockers, 2019 Duan - Beta-blockers, 2018 Darcie - Atenolol, 2004 50.210.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-2.72.41.3530.000Delteil - Beta-blockers, 2024Kubota - Beta-blockers, 2023Mazkereth - Beta-blockers, 2019Duan - Beta-blockers, 2018Darcie - Atenolol, 2004

Asymetry test p-value = 0.1982 (by Egger's regression)

slope=-0.3217 (0.0931); intercept=0.9597 (0.5829); t=1.6464; p=0.1982

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 0.80[0.69; 0.92]23,6855,7570%NADelteil - Beta-blockers, 2024 Duan - Beta-blockers, 2018 2 unexposed, sick controlsunexposed, sick controls 1.44[0.64; 3.25]302040%NAKubota - Beta-blockers, 2023 Mazkereth - Beta-blockers, 2019 Darcie - Atenolol, 2004 30.510.01.0