Proton Pump Inhibitors updated on 08-09-2023

Low Apgar score (< 7) (at 5 min)

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.
S14451
R57337		 Breddels, 2022 Apgar score 5 min after birth (AS5min) < 7 3rd trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes 0.84 [0.66;1.06] -/-   -/- - -
ref
S4444
R10532		 Cluver - Esomeprazole, 2018 Apgar score < 7 at 5 min late pregnancy randomized controlled trial unexposed, sick Adjustment: Randomisation 0.13 [0.02;1.10] C 1/59   7/60 8 59
ref
S4446
R10578		 Matok, 2012 Apgar 5 min ≤ 7 3rd trimester retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: Yes 0.50 [0.19;1.35] 4/-   1,056/- 1,060 -
ref
S4459
R10586		 Källén - Omeprazole, 2001 Low Apgar score (< 7 at 5 min) at least 1st trimester excluded population based cohort retrospective unexposed (general population or NOS) Adjustment: No 0.61 [0.23;1.62]
excluded (exposition period) 		-/-   -/- - -
ref
Total 3 studies 0.60 [0.30;1.23] 1,068 59
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 Breddels, 2022Breddels, 2022 0.84[0.66; 1.06]--61%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Cluver - Esomeprazole, 2018Cluver - Esomeprazole, 2018 0.13[0.02; 1.10]85910%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Matok, 2012Matok, 2012 0.50[0.19; 1.35]1,060-29%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Total (3 studies) I2 = 48% 0.60[0.30; 1.23]1,068590.02.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 0.81[0.64; 1.04]1,060-2%NABreddels, 2022 Matok, 2012 2 case control studiescase control studies 0 RCTRCT 0.13[0.02; 1.10]859 -NACluver - Esomeprazole, 2018 1 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 0.81[0.64; 1.04]1,060-2%NABreddels, 2022 Matok, 2012 2 unexposed, sickunexposed, sick 0.13[0.02; 1.10]859 -NACluver - Esomeprazole, 2018 1 Tags Adjustment   - Randomisation  - Randomisation 0.13[0.02; 1.10]859 -NACluver - Esomeprazole, 2018 1   - Yes  - Yes 0.81[0.64; 1.04]1,060-2%NABreddels, 2022 Matok, 2012 2 All studiesAll studies 0.60[0.30; 1.23]1,0685948%NABreddels, 2022 Cluver - Esomeprazole, 2018 Matok, 2012 30.010.01.0

Publication bias and p-hacking diagnosis

funnel plot

Funnel plot not drawn. Less than 3 points.

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

not enought points

p values plot

Funnel plot not drawn. Less than 3 points.

Sub-groups analysis using all included studies

excluded

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 0.81[0.64; 1.04]1,060-2%NABreddels, 2022 Matok, 2012 2 unexposed, sick controlsunexposed, sick controls Out of scale0.13[0.02; 1.10]859 -NACluver - Esomeprazole, 2018 10.510.01.0