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

Late intrauterine deaths (> 22 weeks) / Stillbirths

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.
S18385
R77573		 Kananen - Quetiapine, 2023 Stillborn during pregnancy (anytime or not specified) retrospective cohort unexposed (general population or NOS) Adjustment: No 2.13 [0.30;15.34] C 1/152   109/35,133 110 152
ref
S3851
R8199		 Ellfolk (Control exposed to FGA), 2019 Stillbirth (gestational age of 22 weeks or more or birth weight of 500 g or more) during pregnancy (anytime or not specified) population based cohort retrospective exposed to other treatment, sick excluded Adjustment: Yes 0.57 [0.20;1.61]
excluded (control group) 		21/4,225   12/1,576 33 4,225
ref
S3818
R8136		 Ellfolk (Control unexposed), 2019 Stillbirth (gestational age of 22 weeks or more or birth weight of 500 g or more) during pregnancy (anytime or not specified) population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes 0.56 [0.23;1.32] 21/4,225   56/21,125 77 4,225
ref
S2294
R8230		 Vigod, 2015 Stillbirth >20 weeks gestation during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, sick Adjustment: No Matched 0.56 [0.25;1.27] 9/1,021   16/1,021 25 1,021
ref
S2341
R8722		 Habermann (Control exposed to FGA), 2013 Stillbirth during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No 0.10 [0.00;2.10] C
excluded (control group) 		0/561   2/284 2 561
ref
S2385
R8723		 Habermann (Control unexposed, disease free), 2013 Stillbirth during pregnancy (anytime or not specified) prospective cohort unexposed, disease free Adjustment: No 0.29 [0.01;5.53] C 0/561   3/1,122 3 561
ref
S2305
R2680		 McKenna, 2005 Stillbirth during pregnancy (anytime or not specified) prospective cohort unexposed, disease free Adjustment: No Matched 1.00 [0.25;4.07] C 4/151   4/151 8 151
ref
Total 5 studies 0.65 [0.39;1.10] 223 6,110
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 Kananen - Quetiapine, 2023Kananen - Quetiapine, 2023 2.13[0.30; 15.34]1101527%ROB confusion: criticalROB selection: unclearROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Ellfolk (Control unexposed), 2019Ellfolk, 2019 1 0.56[0.23; 1.32]774,22535%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: low Vigod, 2015Vigod, 2015 0.56[0.25; 1.27]251,02141%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Habermann (Control unexposed, disease free), 2013Habermann, 2013 2 0.29[0.01; 5.53]35613%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: moderateROB mesure: moderateROB reporting: low McKenna, 2005McKenna, 2005 1.00[0.25; 4.07]815114%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Total (5 studies) I2 = 0% 0.65[0.39; 1.10]2236,1100.25.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Control unexposed; 2: Control unexposed, disease free;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 0.65[0.39; 1.10]2236,1100%NAKananen - Quetiapine, 2023 Ellfolk (Control unexposed), 2019 Vigod, 2015 Habermann (Control unexposed, disease free), 2013 McKenna, 2005 5 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 0.72[0.37; 1.42]1985,0890%NAKananen - Quetiapine, 2023 Ellfolk (Control unexposed), 2019 Habermann (Control unexposed, disease free), 2013 McKenna, 2005 4 unexposed, sickunexposed, sick 0.56[0.25; 1.26]251,021 -NAVigod, 2015 1 Tags Adjustment   - No  - No 0.71[0.37; 1.35]1461,8850%NAKananen - Quetiapine, 2023 Vigod, 2015 Habermann (Control unexposed, disease free), 2013 McKenna, 2005 4   - Yes  - Yes 0.56[0.23; 1.34]774,225 -NAEllfolk (Control unexposed), 2019 1 MatchedMatched 0.65[0.32; 1.31]331,1720%NAVigod, 2015 McKenna, 2005 2 All studiesAll studies 0.65[0.39; 1.10]2236,1100%NAKananen - Quetiapine, 2023 Ellfolk (Control unexposed), 2019 Vigod, 2015 Habermann (Control unexposed, disease free), 2013 McKenna, 2005 50.15.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.63.11.8150.000Kananen - Quetiapine, 2023Ellfolk (Control unexposed), 2019Vigod, 2015Habermann (Control unexposed, disease free), 2013McKenna, 2005

Asymetry test p-value = 0.5268 (by Egger's regression)

slope=-0.7721 (0.5264); intercept=0.6338 (0.8876); t=0.7140; p=0.5268

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 2341, 3851

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 0.72[0.37; 1.42]1985,0890%NAKananen - Quetiapine, 2023 Ellfolk (Control unexposed), 2019 Habermann (Control unexposed, disease free), 2013 McKenna, 2005 4 unexposed, sick controlsunexposed, sick controls 0.56[0.25; 1.26]251,021 -NAVigod, 2015 1 exposed to other treatment, sick controlsexposed to other treatment, sick controls Out of scale0.44[0.13; 1.48]354,78611%NAEllfolk (Control exposed to FGA), 2019 Habermann (Control exposed to FGA), 2013 20.510.01.0

Umbrella review (other published meta-analyses)

Published MAControlPeriodTE95% CIn exposedkI2 Terrana (Stillbirth (fetal death occurring >2 ...Terrana (Stillbirth (fetal death occurring >20 weeks of gestation)) 0.79[0.22; 2.83]0%-U,DFunexposed, disease freeAnyduring pregnancy (anytime or not specified)studies TTT2 metaPregmetaPreg 0.65[0.39; 1.10]0%6,110----Kananen - Quetiapine, 2023 Ellfolk (Control unexposed), 2019 Vigod, 2015 Habermann (Control unexposed, disease free), 2013 McKenna, 2005 50.510.01.0