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

Gestational diabetes

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.
S18338
R77365
Kulkarni - Quetiapine, 2024 Gestational diabetes mellitus at least 1st trimester prospective cohort unexposed, sick Adjustment: No 3.46 [0.70;17.09] C 11/46   2/24 13 46
ref
S14435
R57293
Wang b - HK cohort, 2021 Gestational diabetes mellitus (GDM; using ICD code or a clinician reported GDM) at least 1st trimester retrospective cohort (claims database) unexposed, sick Adjustment: Yes 1.04 [0.58;1.85] 22/149   40/340 62 149
ref
S14433
R57292
Wang b - UK cohort, 2021 Gestational diabetes mellitus (GDM; using Read Code classification or a recorded fasting plasma glucose level of 5.6 mmol/l or above or a 2-h plasma glucose level of 7.8 mmol/l or above) at least 1st trimester retrospective cohort (claims database) unexposed, sick Adjustment: Yes 0.98 [0.51;1.88] 14/349   40/1,577 54 349
ref
S3905
R8273
Schaffer (Controls unexposed, NOS), 2019 Gestational diabetes during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed (general population or NOS) excluded Adjustment: No 1.80 [1.46;2.22] C
excluded (control group)
101/878   9,089/135,252 9,190 878
ref
S3907
R8282
Schaffer (Controls unexposed, sick), 2019 Gestational diabetes during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, sick Adjustment: No 1.79 [1.34;2.40] C 101/878   96/1,419 197 878
ref
S3187
R5104
Park, 2018 Gestational diabetes at least 1st trimester retrospective cohort (claims database) unexposed, sick Adjustment: Yes 1.19 [0.95;1.50] 206/2,872   318/7,507 524 2,872
ref
S2306
R2801
Panchaud, 2017 Gestational diabetes mellitus 1st trimester prospective cohort exposed to other treatment, sick Adjustment: Yes 0.79 [0.40;1.56] 33/303   16/149 49 303
ref
S2336
R2740
Petersen (Control discontinued treatment before pregnancy), 2016 Gestational diabetes 1st trimester retrospective cohort (claims database) unexposed, sick Adjustment: No 0.88 [0.36;2.15] C 9/280   11/302 20 280
ref
S2398
R3008
Petersen (Control unexposed, disease free), 2016 Gestational diabetes 1st trimester retrospective cohort (claims database) unexposed, disease free excluded Adjustment: No 1.99 [1.02;3.87] C
excluded (control group)
9/280   5,227/318,434 5,236 280
ref
S2329
R2698
Bellet - Aripiprazole, 2015 Gestational diabetes 1st trimester prospective cohort unexposed (general population or NOS) Adjustment: No 1.15 [0.33;4.04] 4/86   7/172 11 86
ref
S2294
R3111
Vigod, 2015 Gestational diabetes during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, sick Adjustment: Yes Matched 1.10 [0.77;1.57] 64/923   62/1,021 126 923
ref
S2334
R2737
Hironaka (Control unexposed, disease free), 2011 Gestational diabetes mellitus during pregnancy (anytime or not specified) retrospective cohort unexposed, disease free excluded Adjustment: No 10.84 [0.41;286.05] C
excluded (control group)
0/9   1/278 1 9
ref
S14447
R57308
Hironaka (Control unexposed, sick), 2011 Gestational diabetes mellitus during pregnancy (anytime or not specified) retrospective cohort unexposed, sick Adjustment: No 0.29 [0.00;18.96] C 0/9   0/3 0 9
ref
Total 10 studies 1.22 [1.01;1.47] 1,056 5,895
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 Kulkarni - Quetiapine, 2024Kulkarni - Quetiapine, 2024 3.46[0.70; 17.09]13461%ROB confusion: criticalROB selection: lowROB classification: lowROB missing: lowROB mesure: moderateROB reporting: low Wang b - HK cohort, 2021Wang b - HK cohort, 2021 1.04[0.58; 1.85]621499%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Wang b - UK cohort, 2021Wang b - UK cohort, 2021 0.98[0.51; 1.88]543497%ROB confusion: moderateROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Schaffer (Controls unexposed, sick), 2019Schaffer, 2019 1 1.79[1.34; 2.40]19787823%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Park, 2018Park, 2018 1.19[0.95; 1.50]5242,87229%ROB confusion: moderateROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Panchaud, 2017Panchaud, 2017 0.79[0.40; 1.56]493037%ROB confusion: seriousROB selection: unclearROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Petersen (Control discontinued treatment before pregnancy), 2016Petersen, 2016 2 0.88[0.36; 2.15]202804%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Bellet - Aripiprazole, 2015Bellet - Aripiprazole, 2015 1.15[0.33; 4.04]11862%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: moderateROB mesure: unclearROB reporting: moderate Vigod, 2015Vigod, 2015 1.10[0.77; 1.57]12692318%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Hironaka (Control unexposed, sick), 2011Hironaka, 2011 3 0.29[0.00; 18.96]090%ROB confusion: criticalROB selection: criticalROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Total (10 studies) I2 = 23% 1.22[1.01; 1.47]1,0565,8950.210.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, sick; 2: Control discontinued treatment before pregnancy; 3: Control unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.22[1.01; 1.47]1,0565,89523%NAKulkarni - Quetiapine, 2024 Wang b - HK cohort, 2021 Wang b - UK cohort, 2021 Schaffer (Controls unexposed, sick), 2019 Park, 2018 Panchaud, 2017 Petersen (Control discontinued treatment before pregnancy), 2016 Bellet - Aripiprazole, 2015 Vigod, 2015 Hironaka (Control unexposed, sick), 2011 10 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.15[0.33; 4.02]1186 -NABellet - Aripiprazole, 2015 1 unexposed, sickunexposed, sick 1.26[1.02; 1.55]9965,50629%NAKulkarni - Quetiapine, 2024 Wang b - HK cohort, 2021 Wang b - UK cohort, 2021 Schaffer (Controls unexposed, sick), 2019 Park, 2018 Petersen (Control discontinued treatment before pregnancy), 2016 Vigod, 2015 Hironaka (Control unexposed, sick), 2011 8 exposed to other treatment, sickexposed to other treatment, sick 0.79[0.40; 1.56]49303 -NAPanchaud, 2017 1 Tags Adjustment   - No  - No 1.67[1.27; 2.18]2411,2990%NAKulkarni - Quetiapine, 2024 Schaffer (Controls unexposed, sick), 2019 Petersen (Control discontinued treatment before pregnancy), 2016 Bellet - Aripiprazole, 2015 Hironaka (Control unexposed, sick), 2011 5   - Yes  - Yes 1.11[0.94; 1.32]8154,5960%NAWang b - HK cohort, 2021 Wang b - UK cohort, 2021 Park, 2018 Panchaud, 2017 Vigod, 2015 5 MatchedMatched 1.10[0.77; 1.57]126923 -NAVigod, 2015 1 All studiesAll studies 1.22[1.01; 1.47]1,0565,89523%NAKulkarni - Quetiapine, 2024 Wang b - HK cohort, 2021 Wang b - UK cohort, 2021 Schaffer (Controls unexposed, sick), 2019 Park, 2018 Panchaud, 2017 Petersen (Control discontinued treatment before pregnancy), 2016 Bellet - Aripiprazole, 2015 Vigod, 2015 Hironaka (Control unexposed, sick), 2011 100.110.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-5.05.22.5510.000Kulkarni - Quetiapine, 2024Wang b - HK cohort, 2021Wang b - UK cohort, 2021Schaffer (Controls unexposed, sick), 2019Park, 2018Panchaud, 2017Petersen (Control discontinued treatment before pregnancy), 2016Bellet - Aripiprazole, 2015Vigod, 2015Hironaka (Control unexposed, sick), 2011

Asymetry test p-value = 0.4435 (by Egger's regression)

slope=0.3216 (0.1500); intercept=-0.5220 (0.6476); t=0.8062; p=0.4435

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 2334, 2398, 3905

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.81[1.49; 2.20]14,4381,2530%NASchaffer (Controls unexposed, NOS), 2019 Petersen (Control unexposed, disease free), 2016 Bellet - Aripiprazole, 2015 Hironaka (Control unexposed, disease free), 2011 4 unexposed, sick controlsunexposed, sick controls 1.26[1.02; 1.55]9965,50629%NAKulkarni - Quetiapine, 2024 Wang b - HK cohort, 2021 Wang b - UK cohort, 2021 Schaffer (Controls unexposed, sick), 2019 Park, 2018 Petersen (Control discontinued treatment before pregnancy), 2016 Vigod, 2015 Hironaka (Control unexposed, sick), 2011 8 exposed to other treatment, sick controlsexposed to other treatment, sick controls 0.79[0.40; 1.56]49303 -NAPanchaud, 2017 10.510.01.0

Umbrella review (other published meta-analyses)

Published MAControlPeriodTE95% CIn exposedkI2 Wang (Gestational diabetes mellitus)Wang (Gestational diabetes mellitus) 1.12[0.79; 1.60]35%-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT2 metaPregmetaPreg 1.22[1.01; 1.47]23%5,895----Kulkarni - Quetiapine, 2024 Wang b - HK cohort, 2021 Wang b - UK cohort, 2021 Schaffer (Controls unexposed, sick), 2019 Park, 2018 Panchaud, 2017 Petersen (Control discontinued treatment before pregnancy), 2016 Bellet - Aripiprazole, 2015 Vigod, 2015 Hironaka (Control unexposed, sick), 2011 100.510.01.0