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

Small for gestational age (weight)

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
R77575
Kananen - Quetiapine, 2023 Small for gestational age (ICD-10 diagnoses O36.5) during pregnancy (anytime or not specified) retrospective cohort unexposed (general population or NOS) Adjustment: Yes 1.00 [0.43;2.33] 6/152   879/35,133 885 152
ref
S12451
R46729
Heinonen a (Controls unexposed, NOS), 2022 Small for gestational age ( Z-scores based on infant weight for gestational age and sex < − 2 standard deviations) during pregnancy (anytime or not specified) population based cohort retrospective unexposed (general population or NOS) excluded Adjustment: Yes 1.23 [0.96;1.57]
excluded (control group)
66/1,710   30,102/1,296,539 30,168 1,710
ref
S12450
R46726
Heinonen a (Controls unexposed, sick), 2022 Small for gestational age ( Z-scores based on infant weight for gestational age and sex < − 2 standard deviations) during pregnancy (anytime or not specified) population based cohort retrospective unexposed, sick Adjustment: Yes 1.17 [0.91;1.50] 66/1,710   929/34,492 995 1,710
ref
S12454
R46738
Wang a (Controls exposed to FGA), 2021 Small for gestational age (birth weight <2 standard deviations below the mean for gestational age) during pregnancy (anytime or not specified) retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: No 0.55 [0.15;1.99] C
excluded (control group)
3/199   11/405 14 199
ref
S12453
R46734
Wang a (Controls unexposed, NOS), 2021 Small for gestational age (birth weight <2 standard deviations below the mean for gestational age) during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No 0.88 [0.28;2.76] C 3/199   6,990/410,545 6,993 199
ref
S3851
R8195
Ellfolk (Control exposed to FGA), 2019 Small for gestational age (birth weight of more than two standard deviations less than the sex- and length-of-gestation-specific national standards) during pregnancy (anytime or not specified) population based cohort retrospective exposed to other treatment, sick excluded Adjustment: Yes 0.82 [0.58;1.16]
excluded (control group)
223/4,225   96/1,576 319 4,225
ref
S3818
R8130
Ellfolk (Control unexposed), 2019 Small for gestational age (birth weight of more than two standard deviations less than the sex- and length-of-gestation-specific national standards) during pregnancy (anytime or not specified) population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes 1.02 [0.80;1.30] 223/4,225   779/21,125 1,002 4,225
ref
S3905
R8279
Schaffer (Controls unexposed, NOS), 2019 Small for gestational age (<10th percentile) during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed (general population or NOS) excluded Adjustment: No 1.33 [1.15;1.55] C
excluded (control group)
213/1,322   17,013/135,252 17,226 1,322
ref
S3907
R8288
Schaffer (Controls unexposed, sick), 2019 Small for gestational age (<10th percentile) during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, sick Adjustment: No 0.80 [0.65;0.97] C 213/1,322   276/1,419 489 1,322
ref
S2329
R2697
Bellet - Aripiprazole, 2015 Fetal growth retardation (weight < the 10th percentile for gestational age) 1st trimester prospective cohort unexposed (general population or NOS) Adjustment: No 2.97 [1.23;7.16] 12/63   11/150 23 63
ref
S2294
R8219
Vigod, 2015 Small for gestational age <10th centile during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, sick Adjustment: Yes Matched 1.20 [0.97;1.50] 206/1,021   179/1,021 385 1,021
ref
S2286
R2655
Sadowski, 2013 Small for gestational age (<10th centile) during pregnancy (anytime or not specified) prospective cohort unexposed, disease free Adjustment: No Matched 1.38 [0.58;3.28] C 13/113   10/116 23 113
ref
S3849
R8181
Lin (Control exposed to FGA), 2010 Small for gestational age (birth weight < the 10th percentile for gestational age) during pregnancy (anytime or not specified) population based cohort retrospective exposed to other treatment, sick excluded Adjustment: No 0.78 [0.36;1.68] C
excluded (control group)
10/48   49/194 59 48
ref
S3848
R8177
Lin (Control unexposed, disease free), 2010 Small for gestational age (birth weight < the 10th percentile for gestational age) during pregnancy (anytime or not specified) population based cohort retrospective unexposed, disease free excluded Adjustment: No 1.39 [0.69;2.81] C
excluded (control group)
10/48   553/3,480 563 48
ref
S2331
R2711
Lin (Control unexposed, sick), 2010 Small for gestational age (birth weight < the 10th percentile for gestational age) during pregnancy (anytime or not specified) population based cohort retrospective unexposed, sick Adjustment: Yes 1.15 [0.55;2.41] 10/48   92/454 102 48
ref
S2376
R2904
Newham (Control exposed to FGA), 2008 Small for date (birth weight < 10th percentile for gestational age) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No 0.47 [0.09;2.47] C
excluded (control group)
2/25   7/45 9 25
ref
S2325
R2693
Newham (Control unexposed, disease free), 2008 Small for date (birth weight < 10th percentile for gestational age) during pregnancy (anytime or not specified) prospective cohort unexposed, disease free Adjustment: No 8.33 [0.38;181.51] C 2/25   0/38 2 25
ref
Total 10 studies 1.09 [0.91;1.32] 10,899 8,878
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 1.00[0.43; 2.33]8851524%ROB confusion: seriousROB selection: unclearROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Heinonen a (Controls unexposed, sick), 2022Heinonen a, 2022 1 1.17[0.91; 1.50]9951,71019%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Wang a (Controls unexposed, NOS), 2021Wang a, 2021 2 0.88[0.28; 2.76]6,9931992%ROB confusion: unclearROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Ellfolk (Control unexposed), 2019Ellfolk, 2019 3 1.02[0.80; 1.30]1,0024,22519%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: low Schaffer (Controls unexposed, sick), 2019Schaffer, 2019 4 0.80[0.65; 0.97]4891,32221%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Bellet - Aripiprazole, 2015Bellet - Aripiprazole, 2015 2.97[1.23; 7.16]23634%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: moderateROB mesure: unclearROB reporting: moderate Vigod, 2015Vigod, 2015 1.20[0.97; 1.50]3851,02120%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Sadowski, 2013Sadowski, 2013 1.38[0.58; 3.28]231134%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: criticalROB mesure: moderateROB reporting: moderate Lin (Control unexposed, sick), 2010Lin, 2010 5 1.15[0.55; 2.41]102485%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Newham (Control unexposed, disease free), 2008Newham, 2008 6 8.33[0.38; 181.51]2250%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Total (10 studies) I2 = 48% 1.09[0.91; 1.32]10,8998,8780.220.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, sick; 2: Controls unexposed, NOS; 3: Control unexposed; 4: Controls unexposed, sick; 5: Control unexposed, sick; 6: Control unexposed, disease free;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.09[0.91; 1.32]10,8998,87848%NAKananen - Quetiapine, 2023 Heinonen a (Controls unexposed, sick), 2022 Wang a (Controls unexposed, NOS), 2021 Ellfolk (Control unexposed), 2019 Schaffer (Controls unexposed, sick), 2019 Bellet - Aripiprazole, 2015 Vigod, 2015 Sadowski, 2013 Lin (Control unexposed, sick), 2010 Newham (Control unexposed, disease free), 2008 10 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.26[0.86; 1.86]8,9284,77732%NAKananen - Quetiapine, 2023 Wang a (Controls unexposed, NOS), 2021 Ellfolk (Control unexposed), 2019 Bellet - Aripiprazole, 2015 Sadowski, 2013 Newham (Control unexposed, disease free), 2008 6 unexposed, sickunexposed, sick 1.04[0.81; 1.33]1,9714,10168%NAHeinonen a (Controls unexposed, sick), 2022 Schaffer (Controls unexposed, sick), 2019 Vigod, 2015 Lin (Control unexposed, sick), 2010 4 Tags Adjustment   - No  - No 1.34[0.70; 2.55]7,5301,72265%NAWang a (Controls unexposed, NOS), 2021 Schaffer (Controls unexposed, sick), 2019 Bellet - Aripiprazole, 2015 Sadowski, 2013 Newham (Control unexposed, disease free), 2008 5   - Yes  - Yes 1.13[0.99; 1.29]3,3697,1560%NAKananen - Quetiapine, 2023 Heinonen a (Controls unexposed, sick), 2022 Ellfolk (Control unexposed), 2019 Vigod, 2015 Lin (Control unexposed, sick), 2010 5 MatchedMatched 1.21[0.98; 1.49]4081,1340%NAVigod, 2015 Sadowski, 2013 2 All studiesAll studies 1.09[0.91; 1.32]10,8998,87848%NAKananen - Quetiapine, 2023 Heinonen a (Controls unexposed, sick), 2022 Wang a (Controls unexposed, NOS), 2021 Ellfolk (Control unexposed), 2019 Schaffer (Controls unexposed, sick), 2019 Bellet - Aripiprazole, 2015 Vigod, 2015 Sadowski, 2013 Lin (Control unexposed, sick), 2010 Newham (Control unexposed, disease free), 2008 100.220.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.73.81.8860.000Kananen - Quetiapine, 2023Heinonen a (Controls unexposed, sick), 2022Wang a (Controls unexposed, NOS), 2021Ellfolk (Control unexposed), 2019Schaffer (Controls unexposed, sick), 2019Bellet - Aripiprazole, 2015Vigod, 2015Sadowski, 2013Lin (Control unexposed, sick), 2010Newham (Control unexposed, disease free), 2008

Asymetry test p-value = 0.1515 (by Egger's regression)

slope=-0.1196 (0.1202); intercept=1.0989 (0.6932); t=1.5854; p=0.1515

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 2376, 3849, 3848, 3851, 3905, 12454, 12451

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.25[1.08; 1.43]56,8857,85715%NAKananen - Quetiapine, 2023 Heinonen a (Controls unexposed, NOS), 2022 Wang a (Controls unexposed, NOS), 2021 Ellfolk (Control unexposed), 2019 Schaffer (Controls unexposed, NOS), 2019 Bellet - Aripiprazole, 2015 Sadowski, 2013 Lin (Control unexposed, disease free), 2010 Newham (Control unexposed, disease free), 2008 9 unexposed, sick controlsunexposed, sick controls 1.04[0.81; 1.33]1,9714,10168%NAHeinonen a (Controls unexposed, sick), 2022 Schaffer (Controls unexposed, sick), 2019 Vigod, 2015 Lin (Control unexposed, sick), 2010 4 exposed to other treatment, sick controlsexposed to other treatment, sick controls 0.78[0.58; 1.06]4014,4970%NAWang a (Controls exposed to FGA), 2021 Ellfolk (Control exposed to FGA), 2019 Lin (Control exposed to FGA), 2010 Newham (Control exposed to FGA), 2008 40.510.01.0

Umbrella review (other published meta-analyses)

Published MAControlPeriodTE95% CIn exposedkI2 Terrana (Small for gestational age (<10th per ...Terrana (Small for gestational age (<10th percentile)) 1.58[0.91; 2.74]0%-U,DFunexposed, disease freeAnyduring pregnancy (anytime or not specified)studies TTT3 metaPregmetaPreg 1.09[0.91; 1.32]48%8,878----Kananen - Quetiapine, 2023 Heinonen a (Controls unexposed, sick), 2022 Wang a (Controls unexposed, NOS), 2021 Ellfolk (Control unexposed), 2019 Schaffer (Controls unexposed, sick), 2019 Bellet - Aripiprazole, 2015 Vigod, 2015 Sadowski, 2013 Lin (Control unexposed, sick), 2010 Newham (Control unexposed, disease free), 2008 100.510.01.0