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

Low birth weight (< 2500g)

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
R71954
Vaclavik - Beta-blockers, 2024 Low birth weight during pregnancy (anytime or not specified) population based cohort retrospective unexposed, disease free Adjustment: No Indications Antihypertensive: All hypertensions, any indications or not specified 2.54 [2.34;2.75] -/676   -/66,393 - 676
ref
S13995
R54973
Baard - Beta-blockers, 2020 Low birth weight (< 2 500 g) 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, ...) 1.01 [0.43;2.35] C 9/43   28/135 37 43
ref
S13509
R52191
Fitton - Beta-blockers (Controls unexposed, disease free), 2020 Low birth weight (<2500 g) during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, disease free excluded Adjustment: Yes Indications Antihypertensive: All hypertensions, any indications or not specified 2.46 [1.75;3.45]
excluded (control group)
134/985   11,051/250,693 11,185 985
ref
S14420
R57247
Fitton - Beta-blockers (Controls unexposed, sick), 2020 Low birth weight (<2500 g) during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, sick Adjustment: No Indications Antihypertensive: All hypertensions, any indications or not specified 1.42 [1.16;1.72] C 134/985   797/7,971 931 985
ref
S13902
R54399
Duan - Beta-blockers, 2018 Low birth weight (birth weight <2500g) 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 4.91 [4.58;5.27] C 1,025/4,847   19,393/374,391 20,418 4,847
ref
S13891
R54555
Ishibashi - Beta-blockers, 2017 Low birthweight infants (birth weight less than 2500 kg) 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, ...) 3.25 [1.17;9.09] 15/38   14/87 29 38
ref
S13480
R52000
Orbach - Atenolol, 2013 Low birthweight (< 2500 g) 3rd trimester retrospective cohort (claims database) unexposed, disease free Adjustment: Yes Indications Antihypertensive: All hypertensions, any indications or not specified 3.89 [2.42;6.25] 25/107   10,001/97,820 10,026 107
ref
S13448
R51808
Su - Beta-blockers (Controls unexposed, disease free), 2013 Low birth weight (< 2,500 gm) during pregnancy (anytime or not specified) population based cohort retrospective unexposed, disease free excluded Adjustment: No Indications Antihypertensive: Only chronic hypertension indication 2.67 [1.96;3.63] C
excluded (control group)
52/414   418/8,181 470 414
ref
S13442
R51790
Su - Beta-blockers (Controls unexposed, sick) , 2013 Low birth weight (< 2,500 gm) during pregnancy (anytime or not specified) population based cohort retrospective unexposed, sick Adjustment: Yes Indications Antihypertensive: Only chronic hypertension indication 1.70 [1.17;2.48] 52/414   76/1,006 128 414
ref
S14027
R55128
Rosenfeld - Pindolol, 1986 Low birth weight (< 2500 g) during pregnancy (anytime or not specified) randomized controlled trial unexposed, sick Adjustment: Randomisation Indications Antihypertensive: All hypertensions, any indications or not specified 0.93 [0.28;3.06] C 9/23   9/22 18 23
ref
Total 8 studies 2.24 [1.48;3.40] 31,587 7,133
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 2.54[2.34; 2.75]-67616%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: unclear Baard - Beta-blockers, 2020Baard - Beta-blockers, 2020 1.01[0.43; 2.35]374310%ROB confusion: seriousROB selection: unclearROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Fitton - Beta-blockers (Controls unexposed, sick), 2020Fitton - Beta-blockers, 2020 1 1.42[1.16; 1.72]93198516%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: moderateROB mesure: moderateROB reporting: moderate Duan - Beta-blockers, 2018Duan - Beta-blockers, 2018 4.91[4.58; 5.27]20,4184,84716%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Ishibashi - Beta-blockers, 2017Ishibashi - Beta-blockers, 2017 3.25[1.17; 9.09]29388%ROB confusion: criticalROB selection: criticalROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: low Orbach - Atenolol, 2013Orbach - Atenolol, 2013 3.89[2.42; 6.25]10,02610713%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Su - Beta-blockers (Controls unexposed, sick) , 2013Su - Beta-blockers, 2013 2 1.70[1.17; 2.48]12841414%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Rosenfeld - Pindolol, 1986Rosenfeld - Pindolol, 1986 0.93[0.28; 3.06]18237%ROB confusion: lowROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Total (8 studies) I2 = 97% 2.24[1.48; 3.40]31,5877,1330.210.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, sick; 2: Controls unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 2.40[1.56; 3.68]31,5697,11098%NAVaclavik - Beta-blockers, 2024 Baard - Beta-blockers, 2020 Fitton - Beta-blockers (Controls unexposed, sick), 2020 Duan - Beta-blockers, 2018 Ishibashi - Beta-blockers, 2017 Orbach - Atenolol, 2013 Su - Beta-blockers (Controls unexposed, sick) , 2013 7 case control studiescase control studies 0 RCTRCT 0.93[0.28; 3.06]1823 -NARosenfeld - Pindolol, 1986 1 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 3.63[2.12; 6.20]30,4445,63099%NAVaclavik - Beta-blockers, 2024 Duan - Beta-blockers, 2018 Orbach - Atenolol, 2013 3 unexposed, sickunexposed, sick 1.48[1.22; 1.80]1,1431,5038%NABaard - Beta-blockers, 2020 Fitton - Beta-blockers (Controls unexposed, sick), 2020 Ishibashi - Beta-blockers, 2017 Su - Beta-blockers (Controls unexposed, sick) , 2013 Rosenfeld - Pindolol, 1986 5 Tags Adjustment   - No  - No 2.34[1.39; 3.93]21,4156,58998%NAVaclavik - Beta-blockers, 2024 Baard - Beta-blockers, 2020 Fitton - Beta-blockers (Controls unexposed, sick), 2020 Duan - Beta-blockers, 2018 Ishibashi - Beta-blockers, 2017 5   - Randomisation  - Randomisation 0.93[0.28; 3.06]1823 -NARosenfeld - Pindolol, 1986 1   - Yes  - Yes 2.54[1.13; 5.71]10,15452186%NAOrbach - Atenolol, 2013 Su - Beta-blockers (Controls unexposed, sick) , 2013 2 Indications Antihypertensive   - All hypertensions, any indications ...  - All hypertensions, any indications or not specified 2.55[1.54; 4.21]31,3936,63898%NAVaclavik - Beta-blockers, 2024 Fitton - Beta-blockers (Controls unexposed, sick), 2020 Duan - Beta-blockers, 2018 Orbach - Atenolol, 2013 Rosenfeld - Pindolol, 1986 5   - Only cardiac indications other than ...  - Only cardiac indications other than hypertension (long QT syndrome, structural heart disease, ...) 1.75[0.56; 5.47]668166%NABaard - Beta-blockers, 2020 Ishibashi - Beta-blockers, 2017 2   - Only chronic hypertension indication  - Only chronic hypertension indication 1.70[1.17; 2.48]128414 -NASu - Beta-blockers (Controls unexposed, sick) , 2013 1 All studiesAll studies 2.24[1.48; 3.40]31,5877,13397%NAVaclavik - Beta-blockers, 2024 Baard - Beta-blockers, 2020 Fitton - Beta-blockers (Controls unexposed, sick), 2020 Duan - Beta-blockers, 2018 Ishibashi - Beta-blockers, 2017 Orbach - Atenolol, 2013 Su - Beta-blockers (Controls unexposed, sick) , 2013 Rosenfeld - Pindolol, 1986 80.210.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-1.92.20.7300.000Vaclavik - Beta-blockers, 2024Baard - Beta-blockers, 2020Fitton - Beta-blockers (Controls unexposed, sick), 2020Duan - Beta-blockers, 2018Ishibashi - Beta-blockers, 2017Orbach - Atenolol, 2013Su - Beta-blockers (Controls unexposed, sick) , 2013Rosenfeld - Pindolol, 1986

Asymetry test p-value = 0.2986 (by Egger's regression)

slope=1.3931 (0.2135); intercept=-3.3476 (2.9424); t=1.1377; p=0.2986

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 13448, 13509

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 3.17[2.12; 4.73]42,0997,02997%NAVaclavik - Beta-blockers, 2024 Fitton - Beta-blockers (Controls unexposed, disease free), 2020 Duan - Beta-blockers, 2018 Orbach - Atenolol, 2013 Su - Beta-blockers (Controls unexposed, disease free), 2013 5 unexposed, sick controlsunexposed, sick controls 1.48[1.22; 1.80]1,1431,5038%NABaard - Beta-blockers, 2020 Fitton - Beta-blockers (Controls unexposed, sick), 2020 Ishibashi - Beta-blockers, 2017 Su - Beta-blockers (Controls unexposed, sick) , 2013 Rosenfeld - Pindolol, 1986 50.510.01.0