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

Low Apgar score (< 7) (at 1 min)

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.
S13863
R54229		 Mazkereth - Beta-blockers, 2019 Apgar 1 min < 7 during pregnancy (anytime or not specified) retrospective cohort unexposed, sick Adjustment: No Indications Antihypertensive: All hypertensions, any indications or not specified Matched 0.50 [0.04;5.54] C 1/153   2/153 3 153
ref
S13902
R54401		 Duan - Beta-blockers, 2018 Low APGAR score (<7) at 1 min 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 2.38 [2.17;2.62] C 487/4,847   16,755/374,391 17,242 4,847
ref
S14079
R55425		 Gandjbakhch - Beta-blockers, 2018 Apgar 1 min < 7 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, ...) 0.95 [0.04;24.78] C 0/13   1/37 1 13
ref
S13480
R52002		 Orbach - Atenolol, 2013 Apgar score <=7 at 1 min 3rd trimester retrospective cohort (claims database) unexposed, disease free Adjustment: Yes Indications Antihypertensive: All hypertensions, any indications or not specified 2.65 [1.52;4.61] 15/107   5,790/97,820 5,805 107
ref
S13846
R54251		 Darcie - Atenolol, 2004 Apgar score (first minute) < 7 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 2.38 [2.16;2.61] 23,057 5,160
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 Mazkereth - Beta-blockers, 2019Mazkereth - Beta-blockers, 2019 0.50[0.04; 5.54]31530%ROB confusion: criticalROB selection: criticalROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Duan - Beta-blockers, 2018Duan - Beta-blockers, 2018 2.38[2.17; 2.62]17,2424,84797%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Gandjbakhch - Beta-blockers, 2018Gandjbakhch - Beta-blockers, 2018 0.95[0.04; 24.78]1130%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: unclearROB mesure: criticalROB reporting: moderate Orbach - Atenolol, 2013Orbach - Atenolol, 2013 2.65[1.52; 4.61]5,8051073%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Darcie - Atenolol, 2004Darcie - Atenolol, 2004 0.67[0.11; 4.11]6400%ROB confusion: seriousROB selection: criticalROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Total (5 studies) I2 = 0% 2.38[2.16; 2.61]23,0575,1600.210.01.0ROB: 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 2.38[2.16; 2.61]23,0575,1600%NAMazkereth - Beta-blockers, 2019 Duan - Beta-blockers, 2018 Gandjbakhch - Beta-blockers, 2018 Orbach - Atenolol, 2013 Darcie - Atenolol, 2004 5 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 2.39[2.18; 2.63]23,0474,9540%NADuan - Beta-blockers, 2018 Orbach - Atenolol, 2013 2 unexposed, sickunexposed, sick 0.65[0.17; 2.44]102060%NAMazkereth - Beta-blockers, 2019 Gandjbakhch - Beta-blockers, 2018 Darcie - Atenolol, 2004 3 Tags Adjustment   - No  - No 1.70[0.82; 3.52]17,2525,05321%NAMazkereth - Beta-blockers, 2019 Duan - Beta-blockers, 2018 Gandjbakhch - Beta-blockers, 2018 Darcie - Atenolol, 2004 4   - Yes  - Yes 2.65[1.52; 4.62]5,805107 -NAOrbach - Atenolol, 2013 1 Indications Antihypertensive   - All hypertensions, any indications ...  - All hypertensions, any indications or not specified 2.32[1.76; 3.05]23,0565,14718%NAMazkereth - Beta-blockers, 2019 Duan - Beta-blockers, 2018 Orbach - Atenolol, 2013 Darcie - Atenolol, 2004 4   - Only cardiac indications other than ...  - Only cardiac indications other than hypertension (long QT syndrome, structural heart disease, ...) 0.95[0.04; 24.78]113 -NAGandjbakhch - Beta-blockers, 2018 1 MatchedMatched 0.50[0.04; 5.54]3153 -NAMazkereth - Beta-blockers, 2019 1 All studiesAll studies 2.38[2.16; 2.61]23,0575,1600%NAMazkereth - Beta-blockers, 2019 Duan - Beta-blockers, 2018 Gandjbakhch - Beta-blockers, 2018 Orbach - Atenolol, 2013 Darcie - Atenolol, 2004 50.210.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.94.81.9990.000Mazkereth - Beta-blockers, 2019Duan - Beta-blockers, 2018Gandjbakhch - Beta-blockers, 2018Orbach - Atenolol, 2013Darcie - Atenolol, 2004

Asymetry test p-value = 0.1460 (by Egger's regression)

slope=0.9143 (0.0441); intercept=-0.8081 (0.4140); t=1.9517; p=0.1460

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) 2.39[2.18; 2.63]23,0474,9540%NADuan - Beta-blockers, 2018 Orbach - Atenolol, 2013 2 unexposed, sick controlsunexposed, sick controls 0.65[0.17; 2.44]102060%NAMazkereth - Beta-blockers, 2019 Gandjbakhch - Beta-blockers, 2018 Darcie - Atenolol, 2004 30.510.01.0