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

Congenital heart defects

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.
S18393
R77587		 Chan (Controls exposed to FGA), 2024 Cardiac malformations at least 1st trimester retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: No 1.65 [0.68;4.02] C
excluded (control group) 		13/419   8/420 21 419
ref
S18339
R77369		 Chan (Controls unexposed, general pop), 2024 Cardiac malformations at least 1st trimester retrospective cohort (claims database) unexposed (general population or NOS) excluded Adjustment: Yes 1.66 [0.68;4.37]
excluded (control group) 		13/419   8,218/464,017 8,231 419
ref
S18392
R77581		 Chan (Controls unexposed, sick), 2024 Cardiac malformations at least 1st trimester retrospective cohort (claims database) unexposed, sick Adjustment: Yes 1.57 [0.60;4.49] 11/363   135/6,476 146 363
ref
S14276
R56332		 Huybrechts (Controls unexposed, NOS), 2023 Cardiovascular Malformations 1st trimester population based cohort retrospective unexposed (general population or NOS) excluded Adjustment: Yes 1.07 [0.95;1.19]
excluded (control group) 		-/21,751   -/6,455,324 - 21,751
ref
S14299
R56345		 Huybrechts (Controls unexposed, sick), 2023 Cardiovascular Malformations 1st trimester population based cohort retrospective unexposed, sick Adjustment: Yes 1.09 [0.96;1.23] -/17,068   -/318,731 - 17,068
ref
S12436
R46675		 Anderson, 2020 Any heart defect 1st trimester case control unexposed (general population or NOS) Adjustment: No 1.50 [0.70;3.00] 18/30   11,803/23,261 11,821 30
ref
S2341
R2755		 Habermann (Control exposed to FGA), 2013 Malformations Cardiovascular system 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No 1.50 [0.48;4.71]
excluded (control group) 		12/430   3/213 15 430
ref
S2385
R2933		 Habermann (Control unexposed, disease free), 2013 Malformations Cardiovascular system 1st trimester prospective cohort unexposed, disease free Adjustment: No 3.21 [1.34;7.67] 12/430   6/1,014 18 430
ref
Total 4 studies 1.50 [0.94;2.40] 11,985 17,891
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 Chan (Controls unexposed, sick), 2024Chan, 2024 1 1.57[0.60; 4.49]14636315%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Huybrechts (Controls unexposed, sick), 2023Huybrechts, 2023 2 1.09[0.96; 1.23]-17,06845%ROB confusion: moderateROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: unclearROB reporting: moderate Anderson, 2020Anderson, 2020 1.50[0.70; 3.00]11,8213022%ROB confusion: criticalROB selection: criticalROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Habermann (Control unexposed, disease free), 2013Habermann, 2013 3 3.21[1.34; 7.67]1843018%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: moderateROB mesure: criticalROB reporting: low Total (4 studies) I2 = 56% 1.50[0.94; 2.40]11,98517,8910.510.01.0ROB: 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, disease free;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.60[0.81; 3.16]16417,86168%NAChan (Controls unexposed, sick), 2024 Huybrechts (Controls unexposed, sick), 2023 Habermann (Control unexposed, disease free), 2013 3 case control studiescase control studies 1.50[0.72; 3.11]11,82130 -NAAnderson, 2020 1 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 2.11[1.00; 4.43]11,83946042%NAAnderson, 2020 Habermann (Control unexposed, disease free), 2013 2 unexposed, sickunexposed, sick 1.10[0.97; 1.24]14617,4310%NAChan (Controls unexposed, sick), 2024 Huybrechts (Controls unexposed, sick), 2023 2 Tags Adjustment   - No  - No 2.11[1.00; 4.43]11,83946042%NAAnderson, 2020 Habermann (Control unexposed, disease free), 2013 2   - Yes  - Yes 1.10[0.97; 1.24]14617,4310%NAChan (Controls unexposed, sick), 2024 Huybrechts (Controls unexposed, sick), 2023 2 All studiesAll studies 1.50[0.94; 2.40]11,98517,89156%NAChan (Controls unexposed, sick), 2024 Huybrechts (Controls unexposed, sick), 2023 Anderson, 2020 Habermann (Control unexposed, disease free), 2013 40.510.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-1.41.60.6160.000Chan (Controls unexposed, sick), 2024Huybrechts (Controls unexposed, sick), 2023Anderson, 2020Habermann (Control unexposed, disease free), 2013

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 2341, 14276, 18393, 18339

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.51[0.93; 2.46]20,07022,63060%NAChan (Controls unexposed, general pop), 2024 Huybrechts (Controls unexposed, NOS), 2023 Anderson, 2020 Habermann (Control unexposed, disease free), 2013 4 unexposed, sick controlsunexposed, sick controls 1.10[0.97; 1.24]14617,4310%NAChan (Controls unexposed, sick), 2024 Huybrechts (Controls unexposed, sick), 2023 2 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.59[0.79; 3.21]368490%NAChan (Controls exposed to FGA), 2024 Habermann (Control exposed to FGA), 2013 20.510.01.0