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

Large 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
R77576		 Kananen - Quetiapine, 2023 Large for gestational age (ICD-10 diagnoses O36.§) during pregnancy (anytime or not specified) retrospective cohort unexposed (general population or NOS) Adjustment: Yes 0.86 [0.34;2.17] 5/152   959/35,133 964 152
ref
S12451
R46730		 Heinonen a (Controls unexposed, NOS), 2022 Large 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 1.58 [1.28;1.96]
excluded (control group) 		85/1,710   41,873/1,296,539 41,958 1,710
ref
S12450
R46727		 Heinonen a (Controls unexposed, sick), 2022 Large 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 1.32 [1.06;1.63] 85/1,710   1,410/34,492 1,495 1,710
ref
S3851
R8200		 Ellfolk (Control exposed to FGA), 2019 Large for gestational age ( birth weight of more than two standard deviations more 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 1.89 [1.20;2.99]
excluded (control group) 		159/4,225   46/1,576 205 4,225
ref
S3818
R8132		 Ellfolk (Control unexposed), 2019 Large for gestational age ( birth weight of more than two standard deviations more 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 1.57 [1.14;2.16] 159/4,225   455/21,125 614 4,225
ref
S3905
R8280		 Schaffer (Controls unexposed, NOS), 2019 Large for gestational age (>90th percentile) during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed (general population or NOS) excluded Adjustment: No 0.98 [0.82;1.18] C
excluded (control group) 		131/1,322   13,619/135,252 13,750 1,322
ref
S3907
R8289		 Schaffer (Controls unexposed, sick), 2019 Large for gestational age (>90th percentile) during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, sick Adjustment: No 1.21 [0.93;1.57] C 131/1,322   118/1,419 249 1,322
ref
S2294
R8220		 Vigod, 2015 Large for gestational age >90th centile during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, sick Adjustment: Yes Matched 1.07 [0.76;1.51] 88/1,021   77/1,021 165 1,021
ref
S2286
R2656		 Sadowski, 2013 Large for gestational age (> 90th centile) during pregnancy (anytime or not specified) prospective cohort unexposed, disease free Adjustment: No Matched 3.64 [1.15;11.53] C 13/113   4/116 17 113
ref
S3849
R8182		 Lin (Control exposed to FGA), 2010 Large for gestational age (> 90th centile) during pregnancy (anytime or not specified) population based cohort retrospective exposed to other treatment, sick excluded Adjustment: No 0.80 [0.22;2.87] C
excluded (control group) 		3/48   15/194 18 48
ref
S3848
R8178		 Lin (Control unexposed, disease free), 2010 Large for gestational age (> 90th centile) during pregnancy (anytime or not specified) population based cohort retrospective unexposed, disease free excluded Adjustment: No 0.70 [0.22;2.26] C
excluded (control group) 		3/48   303/3,480 306 48
ref
S2331
R2712		 Lin (Control unexposed, sick), 2010 Large for gestational age (> 90th centile) during pregnancy (anytime or not specified) population based cohort retrospective unexposed, sick Adjustment: Yes 0.55 [0.16;1.85] 3/48   44/454 47 48
ref
S2376
R2902		 Newham (Control exposed to FGA), 2008 Large for gestational age (birth weight > 90th percentile for gestational age) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No 11.00 [1.21;100.39] C
excluded (control group) 		5/25   1/45 6 25
ref
S2325
R2691		 Newham (Control unexposed, disease free), 2008 Large for gestational age (birth weight > 90th percentile for gestational age) during pregnancy (anytime or not specified) prospective cohort unexposed, disease free Adjustment: No 9.25 [1.01;84.74] C 5/25   1/38 6 25
ref
Total 8 studies 1.29 [1.05;1.59] 3,557 8,616
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 0.86[0.34; 2.17]9641524%ROB confusion: seriousROB selection: unclearROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Heinonen a (Controls unexposed, sick), 2022Heinonen a, 2022 1 1.32[1.06; 1.63]1,4951,71027%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Ellfolk (Control unexposed), 2019Ellfolk, 2019 2 1.57[1.14; 2.16]6144,22520%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: low Schaffer (Controls unexposed, sick), 2019Schaffer, 2019 3 1.21[0.93; 1.57]2491,32224%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Vigod, 2015Vigod, 2015 1.07[0.76; 1.51]1651,02119%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Sadowski, 2013Sadowski, 2013 3.64[1.15; 11.53]171133%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: criticalROB mesure: moderateROB reporting: moderate Lin (Control unexposed, sick), 2010Lin, 2010 4 0.55[0.16; 1.85]47483%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Newham (Control unexposed, disease free), 2008Newham, 2008 5 9.25[1.01; 84.74]6251%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Total (8 studies) I2 = 40% 1.29[1.05; 1.59]3,5578,6160.220.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

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

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.29[1.05; 1.59]3,5578,61640%NAKananen - Quetiapine, 2023 Heinonen a (Controls unexposed, sick), 2022 Ellfolk (Control unexposed), 2019 Schaffer (Controls unexposed, sick), 2019 Vigod, 2015 Sadowski, 2013 Lin (Control unexposed, sick), 2010 Newham (Control unexposed, disease free), 2008 8 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.82[0.94; 3.53]1,6014,51551%NAKananen - Quetiapine, 2023 Ellfolk (Control unexposed), 2019 Sadowski, 2013 Newham (Control unexposed, disease free), 2008 4 unexposed, sickunexposed, sick 1.22[1.05; 1.41]1,9564,1010%NAHeinonen a (Controls unexposed, sick), 2022 Schaffer (Controls unexposed, sick), 2019 Vigod, 2015 Lin (Control unexposed, sick), 2010 4 Tags Adjustment   - No  - No 2.46[0.81; 7.46]2721,46068%NASchaffer (Controls unexposed, sick), 2019 Sadowski, 2013 Newham (Control unexposed, disease free), 2008 3   - Yes  - Yes 1.26[1.03; 1.54]3,2857,15624%NAKananen - Quetiapine, 2023 Heinonen a (Controls unexposed, sick), 2022 Ellfolk (Control unexposed), 2019 Vigod, 2015 Lin (Control unexposed, sick), 2010 5 MatchedMatched 1.74[0.54; 5.61]1821,13475%NAVigod, 2015 Sadowski, 2013 2 All studiesAll studies 1.29[1.05; 1.59]3,5578,61640%NAKananen - Quetiapine, 2023 Heinonen a (Controls unexposed, sick), 2022 Ellfolk (Control unexposed), 2019 Schaffer (Controls unexposed, sick), 2019 Vigod, 2015 Sadowski, 2013 Lin (Control unexposed, sick), 2010 Newham (Control unexposed, disease free), 2008 80.220.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-2.72.91.3560.000Kananen - Quetiapine, 2023Heinonen a (Controls unexposed, sick), 2022Ellfolk (Control unexposed), 2019Schaffer (Controls unexposed, sick), 2019Vigod, 2015Sadowski, 2013Lin (Control unexposed, sick), 2010Newham (Control unexposed, disease free), 2008

Asymetry test p-value = 0.6202 (by Egger's regression)

slope=0.1851 (0.1634); intercept=0.4479 (0.8576); t=0.5223; p=0.6202

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

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

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.37[0.98; 1.90]57,6157,59572%NAKananen - Quetiapine, 2023 Heinonen a (Controls unexposed, NOS), 2022 Ellfolk (Control unexposed), 2019 Schaffer (Controls unexposed, NOS), 2019 Sadowski, 2013 Lin (Control unexposed, disease free), 2010 Newham (Control unexposed, disease free), 2008 7 unexposed, sick controlsunexposed, sick controls 1.22[1.05; 1.41]1,9564,1010%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 1.89[0.71; 5.01]2294,29852%NAEllfolk (Control exposed to FGA), 2019 Lin (Control exposed to FGA), 2010 Newham (Control exposed to FGA), 2008 30.510.01.0

Umbrella review (other published meta-analyses)

Published MAControlPeriodTE95% CIn exposedkI2 Terrana (Large for gestational age (>90th per ...Terrana (Large for gestational age (>90th percentile)) 2.68[0.56; 12.85]72%-U,DFunexposed, disease freeAnyduring pregnancy (anytime or not specified)studies TTT3 metaPregmetaPreg 1.29[1.05; 1.59]40%8,616----Kananen - Quetiapine, 2023 Heinonen a (Controls unexposed, sick), 2022 Ellfolk (Control unexposed), 2019 Schaffer (Controls unexposed, sick), 2019 Vigod, 2015 Sadowski, 2013 Lin (Control unexposed, sick), 2010 Newham (Control unexposed, disease free), 2008 80.510.01.0