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

ASD (Autism spectrum disorder): Diagnosis

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.
S12449
R46724		 Halfdanarson (Controls exposed to FGA), 2022 Autism spectrum disorder (ASD) at age 1 or older (ICD-10 diagnosis of F84.0, F84.1 or F84) during pregnancy (anytime or not specified) population based cohort retrospective exposed to other treatment, sick excluded Adjustment: No 0.86 [0.66;1.13] C
excluded (control group) 		110/7,752   113/6,896 223 7,752
ref
S12448
R46722		 Halfdanarson (Controls unexposed, NOS), 2022 Autism spectrum disorder (ASD) at age 1 or older (ICD-10 diagnosis of F84.0, F84.1 or F84) during pregnancy (anytime or not specified) population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes 1.26 [1.03;1.54] 110/7,752   38,436/4,308,620 38,546 7,752
ref
S12466
R46916		 Straub, 2022 Autism spectrum disorder (ASD) (≥ 2 dates with ICD-9 Dx 299.xx) - By 8 years of age 2nd and/or 3rd trimester retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: Yes 1.05 [0.82;1.33] 90/9,390   13,429/3,309,095 13,519 9,390
ref
S12454
R46737		 Wang a (Controls exposed to FGA), 2021 Autism spectrum disorder (ASD) - (ICD-9-CM: 299) - At least 3 years during pregnancy (anytime or not specified) retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: No 0.37 [0.11;1.29] C
excluded (control group) 		3/199   16/405 19 199
ref
S12453
R46733		 Wang a (Controls unexposed, NOS), 2021 Autism spectrum disorder (ASD) - (ICD-9-CM: 299) - At least 3 years during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No 0.71 [0.23;2.21] C 3/199   8,688/410,545 8,691 199
ref
S12458
R47070		 Yeh, 2021 Autism spectrum disorder (ASD - at least twice outpatient visits within each year for ICD-9 code: 299) - At 0-10 years old during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, sick Adjustment: Yes 1.96 [0.21;18.32] -/45   -/5,243 - 45
ref
Total 4 studies 1.16 [1.00;1.35] 60,756 17,386
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 Halfdanarson (Controls unexposed, NOS), 2022Halfdanarson, 2022 1 1.26[1.03; 1.54]38,5467,75258%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: lowROB mesure: criticalROB reporting: moderate Straub, 2022Straub, 2022 1.05[0.82; 1.33]13,5199,39040%ROB confusion: moderateROB selection: lowROB classification: criticalROB missing: unclearROB mesure: criticalROB reporting: moderate Wang a (Controls unexposed, NOS), 2021Wang a, 2021 2 0.71[0.23; 2.21]8,6911992%ROB confusion: unclearROB selection: lowROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Yeh, 2021Yeh, 2021 1.96[0.21; 18.32]-450%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: unclearROB mesure: criticalROB reporting: critical Total (4 studies) I2 = 0% 1.16[1.00; 1.35]60,75617,3860.25.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, NOS; 2: Controls unexposed, NOS;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.16[1.00; 1.35]60,75617,3860%NAHalfdanarson (Controls unexposed, NOS), 2022 Straub, 2022 Wang a (Controls unexposed, NOS), 2021 Yeh, 2021 4 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.16[0.99; 1.35]60,75617,3411%NAHalfdanarson (Controls unexposed, NOS), 2022 Straub, 2022 Wang a (Controls unexposed, NOS), 2021 3 unexposed, sickunexposed, sick 1.96[0.21; 18.31]-45 -NAYeh, 2021 1 Tags Adjustment   - No  - No 0.71[0.23; 2.21]8,691199 -NAWang a (Controls unexposed, NOS), 2021 1   - Yes  - Yes 1.17[1.00; 1.37]52,06517,1870%NAHalfdanarson (Controls unexposed, NOS), 2022 Straub, 2022 Yeh, 2021 3 All studiesAll studies 1.16[1.00; 1.35]60,75617,3860%NAHalfdanarson (Controls unexposed, NOS), 2022 Straub, 2022 Wang a (Controls unexposed, NOS), 2021 Yeh, 2021 40.25.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-2.72.81.3680.000Halfdanarson (Controls unexposed, NOS), 2022Straub, 2022Wang a (Controls unexposed, NOS), 2021Yeh, 2021

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

not enought points

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 12454, 12449

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.16[0.99; 1.35]60,75617,3411%NAHalfdanarson (Controls unexposed, NOS), 2022 Straub, 2022 Wang a (Controls unexposed, NOS), 2021 3 unexposed, sick controlsunexposed, sick controls 1.96[0.21; 18.31]-45 -NAYeh, 2021 1 exposed to other treatment, sick controlsexposed to other treatment, sick controls 0.71[0.36; 1.43]2427,95141%NAHalfdanarson (Controls exposed to FGA), 2022 Wang a (Controls exposed to FGA), 2021 20.510.01.0