Atypical antipsychotics (Second generation) updated on 06-10-2025

Neonatal medical care

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.
S18401
R77648
Kernizan (Controls exposed to LTG), 2024 Neonatal intensive care unit (NICU) admission during pregnancy (anytime or not specified) retrospective cohort exposed to other treatment, sick excluded Adjustment: No 0.71 [0.18;2.75] C
excluded (control group)
11/46   4/13 15 46
ref
S18348
R77394
Kernizan (Controls unexposed, sick), 2024 Neonatal intensive care unit (NICU) admission during pregnancy (anytime or not specified) retrospective cohort unexposed, sick Adjustment: No 0.84 [0.39;1.81] C 11/46   38/139 49 46
ref
S18338
R77367
Kulkarni - Quetiapine, 2024 Neonatal Intensive Care Unit or Special Care Nursery admission at least 1st trimester excluded prospective cohort unexposed, sick Adjustment: No 1.30 [0.46;3.62] C
excluded (exposition period)
20/44   9/23 29 44
ref
S18385
R77536
Kananen - Quetiapine, 2023 Admission to neonatal intensive care unit (NICU) during pregnancy (anytime or not specified) retrospective cohort unexposed (general population or NOS) Adjustment: Yes 1.13 [0.78;1.63] 45/152   5,464/35,133 5,509 152
ref
S14268
R56086
Viguera b, 2023 Admission to Neonatal Intensive Care Unit during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick Adjustment: No 0.76 [0.46;1.26] C 34/193   42/191 76 193
ref
S14275
R56120
Heinonen b (Controls exposed to FGA), 2022 Neonatal intensive care unit (NICU) admission late pregnancy population based cohort retrospective exposed to other treatment, sick excluded Adjustment: No 0.84 [0.62;1.13] C
excluded (control group)
208/972   73/297 281 972
ref
S14274
R56118
Heinonen b (Controls unexposed, NOS), 2022 Neonatal intensive care unit (NICU) admission late pregnancy population based cohort retrospective unexposed (general population or NOS) excluded Adjustment: Yes 1.80 [1.60;2.00]
excluded (control group)
208/972   98,976/1,262,047 99,184 972
ref
S14273
R56116
Heinonen b (Controls unexposed, sick), 2022 Neonatal intensive care unit (NICU) admission late pregnancy population based cohort retrospective unexposed, sick Adjustment: Yes 1.50 [1.30;1.70] 208/972   4,010/34,492 4,218 972
ref
S3851
R8203
Ellfolk (Control exposed to FGA), 2019 Neonatal care or intensive care unit during pregnancy (anytime or not specified) population based cohort retrospective exposed to other treatment, sick excluded Adjustment: Yes 0.93 [0.77;1.13]
excluded (control group)
990/4,204   335/1,564 1,325 4,204
ref
S3818
R8139
Ellfolk (Control unexposed), 2019 Neonatal care or intensive care unit (NCU) during pregnancy (anytime or not specified) population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes 1.46 [1.27;1.68] 990/4,204   2,134/21,069 3,124 4,204
ref
S3905
R8278
Schaffer (Controls unexposed, NOS), 2019 Admission to neonatal intensive care unit (NICU) or special care nursery during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed (general population or NOS) excluded Adjustment: No 2.68 [2.39;3.00] C
excluded (control group)
473/1,320   23,314/135,087 23,787 1,320
ref
S3907
R8287
Schaffer (Controls unexposed, sick), 2019 Admission to neonatal intensive care unit (NICU) or special care nursery during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, sick Adjustment: No 1.21 [1.03;1.42] C 473/1,320   447/1,416 920 1,320
ref
S2378
R2912
Frayne (Control exposed to antidepressants), 2018 Moderate resuscitation during pregnancy (anytime or not specified) retrospective cohort exposed to other treatment, sick excluded Adjustment: No 0.54 [0.23;1.24] C
excluded (control group)
14/75   15/50 29 75
ref
S2285
R2651
Frayne (Control unexposed, sick), 2018 Moderate resuscitation during pregnancy (anytime or not specified) retrospective cohort unexposed, sick Adjustment: No 1.10 [0.45;2.70] C 14/75   10/58 24 75
ref
S2362
R2865
Sutter-Dallay, 2015 Neonatal hospitalization during pregnancy (anytime or not specified) retrospective cohort unexposed, sick Adjustment: Yes 2.21 [1.16;4.21] -/55   -/- - 55
ref
S2294
R8221
Vigod, 2015 Neonatal respiratory distress syndrome during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, sick Adjustment: Yes Matched 0.82 [0.46;1.43] 26/1,021   30/1,021 56 1,021
ref
S2286
R2659
Sadowski, 2013 Admitted in the neonatal intensive care unit (NICU) during pregnancy (anytime or not specified) prospective cohort unexposed, disease free Adjustment: No Matched 2.44 [1.13;5.28] C 23/113   11/116 34 113
ref
S2339
R2747
Newport, 2007 Neonatal intensive care unit admission late pregnancy prospective cohort exposed to other treatment, sick Adjustment: No 4.71 [0.25;89.85] C 6/41   0/13 6 41
ref
Total 11 studies 1.29 [1.11;1.51] 14,016 8,192
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 Kernizan (Controls unexposed, sick), 2024Kernizan, 2024 1 0.84[0.39; 1.81]49463%ROB confusion: unclearROB selection: unclearROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: critical Kananen - Quetiapine, 2023Kananen - Quetiapine, 2023 1.13[0.78; 1.63]5,50915210%ROB confusion: seriousROB selection: unclearROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Viguera b, 2023Viguera b, 2023 0.76[0.46; 1.26]761937%ROB confusion: criticalROB selection: unclearROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: low Heinonen b (Controls unexposed, sick), 2022Heinonen b, 2022 2 1.50[1.30; 1.70]4,21897222%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Ellfolk (Control unexposed), 2019Ellfolk, 2019 3 1.46[1.27; 1.68]3,1244,20421%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: low Schaffer (Controls unexposed, sick), 2019Schaffer, 2019 4 1.21[1.03; 1.42]9201,32020%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Frayne (Control unexposed, sick), 2018Frayne, 2018 5 1.10[0.45; 2.70]24753%ROB confusion: criticalROB selection: moderateROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Sutter-Dallay, 2015Sutter-Dallay, 2015 2.21[1.16; 4.21]-555%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Vigod, 2015Vigod, 2015 0.82[0.46; 1.43]561,0216%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Sadowski, 2013Sadowski, 2013 2.44[1.13; 5.28]341133%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: criticalROB mesure: moderateROB reporting: moderate Newport, 2007Newport, 2007 4.71[0.25; 89.85]6410%ROB confusion: criticalROB selection: unclearROB classification: lowROB missing: lowROB mesure: moderateROB reporting: moderate Total (11 studies) I2 = 53% 1.29[1.11; 1.51]14,0168,1920.210.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, sick; 2: Controls unexposed, sick; 3: Control unexposed; 4: Controls unexposed, sick; 5: Control unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.29[1.11; 1.51]14,0168,19253%NAKernizan (Controls unexposed, sick), 2024 Kananen - Quetiapine, 2023 Viguera b, 2023 Heinonen b (Controls unexposed, sick), 2022 Ellfolk (Control unexposed), 2019 Schaffer (Controls unexposed, sick), 2019 Frayne (Control unexposed, sick), 2018 Sutter-Dallay, 2015 Vigod, 2015 Sadowski, 2013 Newport, 2007 11 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.42[1.10; 1.85]8,6674,46943%NAKananen - Quetiapine, 2023 Ellfolk (Control unexposed), 2019 Sadowski, 2013 3 unexposed, sickunexposed, sick 1.29[1.04; 1.59]5,2673,48955%NAKernizan (Controls unexposed, sick), 2024 Heinonen b (Controls unexposed, sick), 2022 Schaffer (Controls unexposed, sick), 2019 Frayne (Control unexposed, sick), 2018 Sutter-Dallay, 2015 Vigod, 2015 6 exposed to other treatment, sickexposed to other treatment, sick 1.04[0.27; 3.98]8223430%NAViguera b, 2023 Newport, 2007 2 Tags Adjustment   - No  - No 1.15[0.84; 1.57]1,1091,78838%NAKernizan (Controls unexposed, sick), 2024 Viguera b, 2023 Schaffer (Controls unexposed, sick), 2019 Frayne (Control unexposed, sick), 2018 Sadowski, 2013 Newport, 2007 6   - Yes  - Yes 1.40[1.19; 1.64]12,9076,40447%NAKananen - Quetiapine, 2023 Heinonen b (Controls unexposed, sick), 2022 Ellfolk (Control unexposed), 2019 Sutter-Dallay, 2015 Vigod, 2015 5 MatchedMatched 1.37[0.47; 3.98]901,13480%NAVigod, 2015 Sadowski, 2013 2 All studiesAll studies 1.29[1.11; 1.51]14,0168,19253%NAKernizan (Controls unexposed, sick), 2024 Kananen - Quetiapine, 2023 Viguera b, 2023 Heinonen b (Controls unexposed, sick), 2022 Ellfolk (Control unexposed), 2019 Schaffer (Controls unexposed, sick), 2019 Frayne (Control unexposed, sick), 2018 Sutter-Dallay, 2015 Vigod, 2015 Sadowski, 2013 Newport, 2007 110.210.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.53.81.8050.000Kernizan (Controls unexposed, sick), 2024Kananen - Quetiapine, 2023Viguera b, 2023Heinonen b (Controls unexposed, sick), 2022Ellfolk (Control unexposed), 2019Schaffer (Controls unexposed, sick), 2019Frayne (Control unexposed, sick), 2018Sutter-Dallay, 2015Vigod, 2015Sadowski, 2013Newport, 2007

Asymetry test p-value = 0.5272 (by Egger's regression)

slope=0.3564 (0.0917); intercept=-0.4620 (0.7023); t=0.6578; p=0.5272

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 2378, 3851, 3905, 14275, 14274, 18401

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.78[1.32; 2.41]131,6386,76193%NAKananen - Quetiapine, 2023 Heinonen b (Controls unexposed, NOS), 2022 Ellfolk (Control unexposed), 2019 Schaffer (Controls unexposed, NOS), 2019 Sadowski, 2013 5 unexposed, sick controlsunexposed, sick controls 1.29[1.04; 1.59]5,2673,48955%NAKernizan (Controls unexposed, sick), 2024 Heinonen b (Controls unexposed, sick), 2022 Schaffer (Controls unexposed, sick), 2019 Frayne (Control unexposed, sick), 2018 Sutter-Dallay, 2015 Vigod, 2015 6 exposed to other treatment, sick controlsexposed to other treatment, sick controls 0.87[0.75; 1.02]1,7325,5310%NAKernizan (Controls exposed to LTG), 2024 Viguera b, 2023 Heinonen b (Controls exposed to FGA), 2022 Ellfolk (Control exposed to FGA), 2019 Frayne (Control exposed to antidepressants), 2018 Newport, 2007 60.510.01.0