TNF-alpha inhibitors

Small for gestational age (weight)

id	Study   Auto Broms (Controls exposed to other treatments), 2020Broms (Controls unexposed, disease free), 2020De Lorenzo (Controls unexposed, disease free), 2020De Lorenzo (Controls unexposed, sick), 2020Drechsel, 2020Moens (Controls exposed to Vedolizumab), 2020Moens (Controls unexposed, sick), 2020Chaparro, 2018De Lima, 2018Zbinden (rheumatoid arthritis), 2018Zbinden b (axial spondyloarthritis), 2018Hoxha, 2017De Lima (Controls unexposed, disease free), 2016De Lima (Treatment stopped during pregnancy, sick), 2016Agosti, 2015Schnitzler (Controls unexposed, disease free), 2011Schnitzler (Unexposed control, sick), 2011	Lib. in paper	Exposition period  Auto during pregnancy (anytime or not specified)1st trimester2nd trimester3rd trimester2nd and/or 3rd trimesterthroughout pregnancyearly pregnancydays before deliverylate pregnancypreconception-onlypericonceptionalpreconceptional for kinetic reasonat least 1st trimester3 months (or more) before pregnancy or during pregnancy1st and 2nd trimester3 months or more before pregnancy or1st trimester	Study type  All studies Case control excluded Only case control	Control type    Auto unexposed (general population or NOS)unexposed, sickunexposed, disease freeexposed to other treatment, sicknot specifiedsiblingwhatever (meta-analysis)	Tags	OR 95%CI	x1/n1 x0/n0	no cases	no exposed	ROB	Ref.
S4891 R12904	Broms (Controls exposed to other treatments), 2020	Severe small for gestational age (sex-specific weight by gestational age below 2 standard deviations)	during pregnancy (anytime or not specified)	population based cohort retrospective	exposed to other treatment, sick excluded	Adjustment: No	1.34 [0.94;1.90] excluded (control group)	-/-   -/-	-	-		ref
S4890 R12896	Broms (Controls unexposed, disease free), 2020	Small for gestation age (sex-specific weight by gestational age in the 10th percentile or below 2 standard deviations)	3 months (or more) before pregnancy or during pregnancy excluded	population based cohort retrospective	unexposed, disease free	Adjustment: No	1.52 [1.28;1.81] C excluded (exposition period)	147/1,027   160,698/1,623,483	160,845	1,027		ref
S4958 R12995	De Lorenzo (Controls unexposed, disease free), 2020	Small for gestational age	at least 1st trimester	retrospective cohort	unexposed, disease free excluded	Adjustment: No	3.67 [0.63;21.35] C excluded (control group)	3/12   3/36	6	12		ref
S4959 R13001	De Lorenzo (Controls unexposed, sick), 2020	Small for gestational age	at least 1st trimester	retrospective cohort	unexposed, sick	Adjustment: No	5.00 [0.72;34.73] C	3/12   2/32	5	12		ref
S4995 R13091	Drechsel, 2020	Small for gestational age	1st trimester	prospective cohort	unexposed, sick	Adjustment: No	2.46 [0.21;29.20] C	1/14   2/66	3	14		ref
S4952 R12990	Moens (Controls exposed to Vedolizumab), 2020	Small for gestational age (weight below the 10th percentile with regard to gestational age)	at least 1st trimester	retrospective cohort	exposed to other treatment, sick excluded	Adjustment: No	0.39 [0.05;2.81] C excluded (control group)	2/162   2/64	4	162		ref
S4951 R12985	Moens (Controls unexposed, sick), 2020	Small for gestational age (weight below the 10th percentile with regard to gestational age)	at least 1st trimester	retrospective cohort	unexposed, sick	Adjustment: No	0.67 [0.11;4.04] C	2/162   3/163	5	162		ref
S3066 R4658	Chaparro, 2018	Growth retardation (NOS)	3 months (or more) before pregnancy or during pregnancy excluded	retrospective cohort	unexposed, sick	Adjustment: No	1.17 [0.54;2.56] C excluded (exposition period)	13/388   13/453	26	388		ref
S3123 R4859	De Lima, 2018	Small for gestational age (weight below 2 SD for gestational age according to the Dutch reference chart).	at least 1st trimester	prospective cohort	exposed to other treatment, sick	Adjustment: No	0.79 [0.01;43.11] C	0/15   0/12	0	15		ref
S4898 R12942	Zbinden (rheumatoid arthritis), 2018	Small for gestational age (birth weight below the 10th percentile for gestational age).	during pregnancy (anytime or not specified)	prospective cohort	unexposed, disease free	Adjustment: Yes	2.60 [0.81;8.37]	-/28   -/70	-	28		ref
S4899 R12946	Zbinden b (axial spondyloarthritis), 2018	Small for gestational age (birth weight below the 10th percentile for gestational age).	during pregnancy (anytime or not specified)	prospective cohort	unexposed, disease free excluded	Adjustment: Yes	1.30 [0.30;5.60] excluded (control group)	-/31   -/70	-	31		ref
S3009 R4307	Hoxha, 2017	Small for gestational age (< 10th percentile)	1st trimester	prospective cohort	unexposed, sick	Adjustment: No	2.44 [0.11;55.57] C	2/24   0/11	2	24		ref
S3070 R4685	De Lima (Controls unexposed, disease free), 2016	Small for gestational age (weight below the 10th percentile for gestational age)	1st and 2nd trimester	prospective cohort	unexposed, disease free excluded	Adjustment: No	0.47 [0.17;1.32] C excluded (control group)	4/83   78/804	82	83		ref
S3071 R4694	De Lima (Treatment stopped during pregnancy, sick), 2016	Small for gestational age (weight below the 10th percentile for gestational age)	1st and 2nd trimester	prospective cohort	unexposed, sick	Adjustment: No	0.16 [0.01;3.15] C	0/32   4/51	4	32		ref
S3069 R4677	Agosti, 2015	Intrauterine growth restriction (NOS)	during pregnancy (anytime or not specified)	retrospective cohort	unexposed, sick	Adjustment: No	1.00 [0.06;16.97] C	1/24   1/24	2	24		ref
S3017 R4516	Schnitzler (Controls unexposed, disease free), 2011	Very small for gestational age < 5% percentile	3 months (or more) before pregnancy or during pregnancy	prospective cohort	unexposed, disease free excluded	Adjustment: No before conception and/or during pregnancy	0.73 [0.13;4.26] C excluded (control group)	2/32   4/48	6	32		ref
S3018 R4521	Schnitzler (Unexposed control, sick), 2011	Very small for gestational age < 5% percentile	3 months (or more) before pregnancy or during pregnancy excluded	prospective cohort	unexposed, sick	Adjustment: No before conception and/or during pregnancy	0.55 [0.11;2.83] C excluded (exposition period)	2/32   7/65	9	32		ref
					Total	8 studies	1.72 [0.83;3.58]		21	311
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

Sensitivity analysis

Publication bias and p-hacking diagnosis

Sub-groups analysis using all included studies

excluded 3017, 3070, 4899, 4891, 4958, 4952