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

Low Apgar score (< 7) (NOS)

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.
S17156
R71955		 Vaclavik - Beta-blockers, 2024 Neonatal hypoxia (pH <7.1 or Apgar score <8) during pregnancy (anytime or not specified) population based cohort retrospective unexposed, disease free Adjustment: No Indications Antihypertensive: All hypertensions, any indications or not specified 1.57 [1.45;1.70] -/729   -/111,806 - 729
ref
S13995
R54971		 Baard - Beta-blockers, 2020 Apgar scores < 7 (NOS) during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No Indications Antihypertensive: Only cardiac indications other than hypertension (long QT syndrome, structural heart disease, ...) 0.50 [0.16;1.53] C 4/43   23/135 27 43
ref
S14027
R55139		 Rosenfeld - Pindolol, 1986 Asphyxia at birth (Apgar < 7) during pregnancy (anytime or not specified) randomized controlled trial unexposed, sick Adjustment: Randomisation Indications Antihypertensive: All hypertensions, any indications or not specified 0.60 [0.09;4.01] C 2/23   3/22 5 23
ref
Total 3 studies 0.97 [0.40;2.33] 32 795
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 Vaclavik - Beta-blockers, 2024Vaclavik - Beta-blockers, 2024 1.57[1.45; 1.70]-72955%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: unclear Baard - Beta-blockers, 2020Baard - Beta-blockers, 2020 0.50[0.16; 1.53]274329%ROB confusion: seriousROB selection: unclearROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Rosenfeld - Pindolol, 1986Rosenfeld - Pindolol, 1986 0.60[0.09; 4.01]52315%ROB confusion: lowROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Total (3 studies) I2 = 60% 0.97[0.40; 2.33]327950.25.01.0ROB: 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 1.02[0.34; 3.03]2777275%NAVaclavik - Beta-blockers, 2024 Baard - Beta-blockers, 2020 2 case control studiescase control studies 0 RCTRCT 0.60[0.09; 4.01]523 -NARosenfeld - Pindolol, 1986 1 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.57[1.45; 1.70]-729 -NAVaclavik - Beta-blockers, 2024 1 unexposed, sickunexposed, sick 0.52[0.20; 1.38]32660%NABaard - Beta-blockers, 2020 Rosenfeld - Pindolol, 1986 2 Tags Adjustment   - No  - No 1.02[0.34; 3.03]2777275%NAVaclavik - Beta-blockers, 2024 Baard - Beta-blockers, 2020 2   - Randomisation  - Randomisation 0.60[0.09; 4.01]523 -NARosenfeld - Pindolol, 1986 1 Indications Antihypertensive   - All hypertensions, any indications ...  - All hypertensions, any indications or not specified 1.57[1.45; 1.70]57520%NAVaclavik - Beta-blockers, 2024 Rosenfeld - Pindolol, 1986 2   - Only cardiac indications other than ...  - Only cardiac indications other than hypertension (long QT syndrome, structural heart disease, ...) 0.50[0.16; 1.53]2743 -NABaard - Beta-blockers, 2020 1 All studiesAll studies 0.97[0.40; 2.33]3279560%NAVaclavik - Beta-blockers, 2024 Baard - Beta-blockers, 2020 Rosenfeld - Pindolol, 1986 30.25.01.0

Publication bias and p-hacking diagnosis

funnel plot

Funnel plot not drawn. Less than 3 points.

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

not enought points

p values plot

Funnel plot not drawn. Less than 3 points.

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) 1.57[1.45; 1.70]-729 -NAVaclavik - Beta-blockers, 2024 1 unexposed, sick controlsunexposed, sick controls 0.52[0.20; 1.38]32660%NABaard - Beta-blockers, 2020 Rosenfeld - Pindolol, 1986 20.510.01.0

Umbrella review (other published meta-analyses)

Published MAControlPeriodTE95% CIn exposedkI2 Sridharan (Labetalol) (Apgar score < 7 (versu ...Sridharan (Labetalol) (Apgar score < 7 (versus hydralazine)) 1.40[0.80; 2.40]NA-Eexposed to other treatment, sickAnyduring pregnancy (anytime or not specified)studies TTT-9 metaPregmetaPreg 0.97[0.40; 2.33]60%795----Vaclavik - Beta-blockers, 2024 Baard - Beta-blockers, 2020 Rosenfeld - Pindolol, 1986 30.510.01.0