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

All congenital malformations (majors, minors, majors and minors, or unspecified)

id	Study   Auto Delteil - Beta-blockers, 2024Bateman_Nordic - Beta-blockers, 2018Bateman_USMAX - Beta-blockers, 2018Hoeltzenbein c - Bisoprolol, 2018Ishibashi - Beta-blockers, 2017Ersboll - Beta-blockers (Controls unexposed, disease free), 2014Ersboll - Beta-blockers (Controls unexposed, sick), 2014Vasilakis-Scaramozza - Beta-blockers, 2013Nakhai-Pour - Beta-blockers, 2010Queisser-Luft - Beta-blockers, 1996Rosenfeld - Pindolol, 1986	Lib. in paper	Exposition period  Auto during pregnancy (anytime or not specified)1st trimester2nd trimester3rd trimester2nd and/or 3rd trimesterthroughout pregnancyearly pregnancydays before deliverylate pregnancypreconception-onlypericonceptionalpreconceptional for kinetic reasonat least 1st trimester3 months (or more) before pregnancy or during pregnancy1st and 2nd trimester3 months or more before pregnancy or1st trimester	Study type  All studies Case control excluded Only case control	Control type    Auto unexposed (general population or NOS)unexposed, sickunexposed, disease freeexposed to other treatment, sicknot specifiedsiblingwhatever (meta-analysis)	Tags	OR 95%CI	x1/n1 x0/n0	no cases	no exposed	ROB	Ref.
S17127 R73478	Delteil - Beta-blockers, 2024	Major congenital malformations	1st trimester	retrospective cohort (claims database)	unexposed (general population or NOS)	Adjustment: Yes Indications Antihypertensive: Only chronic indication (hypertension or cardiac)	1.54 [1.08;2.13]	36/974   4,054/165,775	4,090	974		ref
S13539 R56246	Bateman_Nordic - Beta-blockers, 2018	Major congenital malformations (ICD-9: 740.xx-759.xx; ICD-10: Q00.0-Q89.9 (except Q17.0, Q38.1, Q53, Q65.0-Q65.6, Q82.5, Q86))	1st trimester	population based cohort retrospective	unexposed, sick	Adjustment: Yes Indications Antihypertensive: All hypertensions, any indications or not specified	1.22 [0.88;1.71]	48/682   152/2,895	200	682		ref
S13791 R56248	Bateman_USMAX - Beta-blockers, 2018	Major congenital malformations (ICD-9: 740.xx-759.xx; ICD-10: Q00.0-Q89.9 (except Q17.0, Q38.1, Q53, Q65.0-Q65.6, Q82.5, Q86))	1st trimester	retrospective cohort (claims database)	unexposed, sick	Adjustment: Yes Indications Antihypertensive: All hypertensions, any indications or not specified	1.01 [0.80;1.27]	78/1,668   534/13,232	612	1,668		ref
S13809 R56261	Hoeltzenbein c - Bisoprolol, 2018	Major birth defects	at least 1st trimester	prospective cohort	unexposed, disease free	Adjustment: Yes Indications Antihypertensive: All hypertensions, any indications or not specified	0.77 [0.34;1.75]	10/294   28/611	38	294		ref
S13891 R54556	Ishibashi - Beta-blockers, 2017	Congenital malformation (no other details)	during pregnancy (anytime or not specified) excluded	retrospective cohort	unexposed, sick	Adjustment: No Indications Antihypertensive: Only cardiac indications other than hypertension (long QT syndrome, structural heart disease, ...)	0.55 [0.06;4.99] excluded (exposition period)	1/38   4/87	5	38		ref
S13958 R54680	Ersboll - Beta-blockers (Controls unexposed, disease free), 2014	Congenital malformations	during pregnancy (anytime or not specified)	retrospective cohort	unexposed, disease free excluded	Adjustment: No Indications Antihypertensive: Only cardiac indications other than hypertension (long QT syndrome, structural heart disease, ...) Matched	1.54 [0.63;3.78] C excluded (control group)	6/51   50/627	56	51		ref
S13957 R54669	Ersboll - Beta-blockers (Controls unexposed, sick), 2014	Congenital malformations	during pregnancy (anytime or not specified) excluded	retrospective cohort	unexposed, sick	Adjustment: No Indications Antihypertensive: Only cardiac indications other than hypertension (long QT syndrome, structural heart disease, ...)	2.62 [0.80;8.56] C excluded (exposition period)	6/51   6/124	12	51		ref
S13935 R56299	Vasilakis-Scaramozza - Beta-blockers, 2013	Any anomaly, excluding minor and chromosomal anomalies	1st trimester	retrospective cohort	unexposed (general population or NOS)	Adjustment: Yes Indications Antihypertensive: All hypertensions, any indications or not specified	1.40 [0.60;3.20]	6/214   16/682	22	214		ref
S13474 R56278	Nakhai-Pour - Beta-blockers, 2010	Major malformations	1st trimester	nested case control	unexposed (general population or NOS)	Adjustment: No Indications Antihypertensive: All hypertensions, any indications or not specified	0.99 [0.31;3.20] C	3/43   4,152/58,990	4,155	43		ref
S13584 R56289	Queisser-Luft - Beta-blockers, 1996	Major malformations	throughout pregnancy	nested case control	unexposed (general population or NOS)	Adjustment: No Indications Antihypertensive: All hypertensions, any indications or not specified	1.10 [0.30;3.40]	-/-   1,481/-	-	-		ref
S14027 R56291	Rosenfeld - Pindolol, 1986	Major malformations	during pregnancy (anytime or not specified) excluded	randomized controlled trial	unexposed, sick	Adjustment: Randomisation Indications Antihypertensive: All hypertensions, any indications or not specified	0.17 [0.01;3.83] C excluded (exposition period)	0/23   2/22	2	23		ref
					Total	7 studies	1.16 [0.99;1.35]		9,117	3,875
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

Sensitivity analysis

Publication bias and p-hacking diagnosis

Sub-groups analysis using all included studies

excluded 13958

Umbrella review (other published meta-analyses)