Acetaminophen (Paracetamol) updated on 09-20-2024

Gastroschisis

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.
S18513
R78667		 Zafeiri, 2022 Gastroschisis during pregnancy (anytime or not specified) excluded retrospective cohort unexposed (general population or NOS) Adjustment: Yes Paracetamol use: maternal ITW/questionnaires during pregnancy 0.99 [0.45;2.21]
excluded (exposition period) 		10/24,099   23/107,143 33 24,099
ref
S18499
R78644		 Goodman, 2019 Gastroschisis diagnosed by ultrasound (less than 24 weeks gestation) during pregnancy (anytime or not specified) excluded case control unexposed (general population or NOS) Adjustment: Yes Matched Paracetamol use: maternal ITW/questionnaires during pregnancy 0.68 [0.25;1.94]
excluded (exposition period) 		18/72   11/33 29 72
ref
S18497
R78639		 Given, 2017 Gastroschisis (excluding diabetes and anti-epileptic medication exposed) 1st trimester case control unexposed (general population or NOS) Adjustment: Yes Paracetamol use: prescription or medical files 1.69 [1.00;2.85] 15/1,038   -/- - 1,038
ref
S18498
R78669		 Robledo-Aceves, 2015 Nonsyndromic gastroschisis 1st trimester case control unexposed (general population or NOS) Adjustment: Yes Paracetamol use: not specified 0.70 [0.30;1.40] 19/61   71/209 90 61
ref
S18501
R79041		 Feldkamp, 2010 Gastroschisis 1st trimester case control unexposed (general population or NOS) Adjustment: Yes Paracetamol use: maternal ITW/questionnaires after pregnancy 1.03 [0.83;1.28] 212/2,168   255/2,442 467 2,168
ref
S18505
R78756		 Rebordosa a, 2008 Gastroschisis 1st trimester prospective cohort unexposed (general population or NOS) Adjustment: Yes Paracetamol use: maternal ITW/questionnaires during pregnancy 0.91 [0.55;4.09] 3/26,424   9/61,718 12 26,424
ref
S18503
R78915		 Werler, 2002 Gastroschisis (newborn infants with intestines protruding through the wall of the abdomen lateral to, but not involving, the umbilicus) 1st trimester case control unexposed (general population or NOS) Adjustment: Yes Matched Paracetamol use: maternal ITW/questionnaires after pregnancy 1.50 [1.00;2.10] 90/412   116/592 206 412
ref
S18504
R78670		 Torfs, 1996 Gastroschisis 1st trimester case control unexposed (general population or NOS) Adjustment: No Matched Paracetamol use: maternal ITW/questionnaires after pregnancy 1.00 [0.59;1.69] 28/84   82/246 110 84
ref
S18502
R78911		 Werler, 1992 Gastroschisis 1st trimester case control unexposed (general population or NOS) Adjustment: Yes Paracetamol use: maternal ITW/questionnaires after pregnancy 1.70 [1.00;2.90] 51/1,126   25/1,092 76 1,126
ref
Total 7 studies 1.21 [0.97;1.51] 961 31,313
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 Given, 2017Given, 2017 1.69[1.00; 2.85]-1,03813%ROB confusion: criticalROB selection: criticalROB classification: criticalROB missing: lowROB mesure: unclearROB reporting: moderate Robledo-Aceves, 2015Robledo-Aceves, 2015 0.70[0.30; 1.40]90617%ROB confusion: criticalROB selection: criticalROB classification: unclearROB missing: unclearROB mesure: unclearROB reporting: moderate Feldkamp, 2010Feldkamp, 2010 1.03[0.83; 1.28]4672,16831%ROB confusion: seriousROB selection: criticalROB classification: criticalROB missing: lowROB mesure: unclearROB reporting: moderate Rebordosa a, 2008Rebordosa a, 2008 0.91[0.55; 4.09]1226,4244%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Werler, 2002Werler, 2002 1.50[1.00; 2.10]20641220%ROB confusion: criticalROB selection: criticalROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Torfs, 1996Torfs, 1996 1.00[0.59; 1.69]1108413%ROB confusion: criticalROB selection: criticalROB classification: criticalROB missing: unclearROB mesure: unclearROB reporting: moderate Werler, 1992Werler, 1992 1.70[1.00; 2.90]761,12612%ROB confusion: criticalROB selection: criticalROB classification: criticalROB missing: lowROB mesure: unclearROB reporting: moderate Total (7 studies) I2 = 34% 1.21[0.97; 1.51]96131,3130.25.01.0ROB: 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 0.91[0.33; 2.48]1226,424 -NARebordosa a, 2008 1 case control studiescase control studies 1.23[0.97; 1.57]9494,88944%NAGiven, 2017 Robledo-Aceves, 2015 Feldkamp, 2010 Werler, 2002 Torfs, 1996 Werler, 1992 6 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.21[0.97; 1.51]96131,31334%NAGiven, 2017 Robledo-Aceves, 2015 Feldkamp, 2010 Rebordosa a, 2008 Werler, 2002 Torfs, 1996 Werler, 1992 7 Tags Adjustment   - No  - No 1.00[0.59; 1.69]11084 -NATorfs, 1996 1   - Yes  - Yes 1.25[0.97; 1.62]85131,22943%NAGiven, 2017 Robledo-Aceves, 2015 Feldkamp, 2010 Rebordosa a, 2008 Werler, 2002 Werler, 1992 6 MatchedMatched 1.28[0.87; 1.89]31649634%NAWerler, 2002 Torfs, 1996 2 Paracetamol use   - maternal ITW/questionnaires after p ...  - maternal ITW/questionnaires after pregnancy 1.23[0.95; 1.58]8593,79043%NAFeldkamp, 2010 Werler, 2002 Torfs, 1996 Werler, 1992 4   - maternal ITW/questionnaires during ...  - maternal ITW/questionnaires during pregnancy 0.91[0.33; 2.48]1226,424 -NARebordosa a, 2008 1   - not specified  - not specified 0.70[0.32; 1.51]9061 -NARobledo-Aceves, 2015 1   - prescription or medical files  - prescription or medical files 1.69[1.00; 2.85]-1,038 -NAGiven, 2017 1 All studiesAll studies 1.21[0.97; 1.51]96131,31334%NAGiven, 2017 Robledo-Aceves, 2015 Feldkamp, 2010 Rebordosa a, 2008 Werler, 2002 Torfs, 1996 Werler, 1992 70.25.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-1.21.40.6140.000Given, 2017Robledo-Aceves, 2015Feldkamp, 2010Rebordosa a, 2008Werler, 2002Torfs, 1996Werler, 1992

Asymetry test p-value = 0.7761 (by Egger's regression)

slope=0.0963 (0.2327); intercept=0.3355 (1.1179); t=0.3002; p=0.7761

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) 1.21[0.97; 1.51]96131,31334%NAGiven, 2017 Robledo-Aceves, 2015 Feldkamp, 2010 Rebordosa a, 2008 Werler, 2002 Torfs, 1996 Werler, 1992 70.510.01.0

Umbrella review (other published meta-analyses)

Published MAControlPeriodTE95% CIn exposedkI2 Baldacci (Gastroschisis)Baldacci (Gastroschisis) 1.16[0.96; 1.41]39%-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT9 metaPregmetaPreg 1.21[0.97; 1.51]34%31,313----Given, 2017 Robledo-Aceves, 2015 Feldkamp, 2010 Rebordosa a, 2008 Werler, 2002 Torfs, 1996 Werler, 1992 70.510.01.0