Proton Pump Inhibitors updated on 08-09-2023

Low birth weight (< 2500g)

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.
S15108
R62070		 Choi b, 2023 Low birth weight (perinatal weight <2.5 kg) during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, sick Adjustment: Yes 0.95 [0.91;1.00] 2,357/41,664   104,056/2,121,323 106,413 41,664
ref
S4515
R11144		 Saleh, 2017 Neonatal (birth) weight <10th percentile according to Perinatal Registration The Netherlands during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No Matched 0.64 [0.24;1.66] C 7/40   20/80 27 40
ref
S4446
R10575		 Matok, 2012 Low birth weight (< 2500 g) 3rd trimester retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: Yes 0.70 [0.48;1.03] 40/666   8,988/108,878 9,028 666
ref
S4459
R10585		 Källén - Omeprazole, 2001 Low birth weight (< 2500g) 2nd and/or 3rd trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: No 1.20 [0.49;2.91] -/-   -/- - -
ref
S4359
R10241		 Nielsen, 1999 Low birth weight (< 2500 g) 2nd and/or 3rd trimester retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: Yes 1.52 [0.20;11.40] 3/39   657/13,327 660 39
ref
Total 5 studies 0.95 [0.90;0.99] 116,128 42,409
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 Choi b, 2023Choi b, 2023 0.95[0.91; 1.00]106,41341,66498%ROB confusion: moderateROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Saleh, 2017Saleh, 2017 0.64[0.24; 1.66]27400%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Matok, 2012Matok, 2012 0.70[0.48; 1.03]9,0286661%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Källén - Omeprazole, 2001Källén - Omeprazole, 2001 1.20[0.49; 2.91]--0%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Nielsen, 1999Nielsen, 1999 1.52[0.20; 11.40]660390%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (5 studies) I2 = 0% 0.95[0.90; 0.99]116,12842,4090.25.01.0ROB: 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 0.95[0.90; 0.99]116,12842,4090%NAChoi b, 2023 Saleh, 2017 Matok, 2012 Källén - Omeprazole, 2001 Nielsen, 1999 5 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 0.78[0.55; 1.10]9,6887050%NAMatok, 2012 Källén - Omeprazole, 2001 Nielsen, 1999 3 unexposed, sickunexposed, sick 0.95[0.91; 0.99]106,44041,7040%NAChoi b, 2023 Saleh, 2017 2 Tags Adjustment   - No  - No 0.89[0.47; 1.72]27400%NASaleh, 2017 Källén - Omeprazole, 2001 2   - Yes  - Yes 0.90[0.74; 1.09]116,10142,36924%NAChoi b, 2023 Matok, 2012 Nielsen, 1999 3 MatchedMatched 0.64[0.24; 1.66]2740 -NASaleh, 2017 1 All studiesAll studies 0.95[0.90; 0.99]116,12842,4090%NAChoi b, 2023 Saleh, 2017 Matok, 2012 Källén - Omeprazole, 2001 Nielsen, 1999 50.25.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-2.42.41.2380.000Choi b, 2023Saleh, 2017Matok, 2012Källén - Omeprazole, 2001Nielsen, 1999

Asymetry test p-value = 0.5821 (by Egger's regression)

slope=-0.0459 (0.0293); intercept=-0.3388 (0.5511); t=0.6149; p=0.5821

p values plot
0.01.00.01.0

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) 0.78[0.55; 1.10]9,6887050%NAMatok, 2012 Källén - Omeprazole, 2001 Nielsen, 1999 3 unexposed, sick controlsunexposed, sick controls 0.95[0.91; 0.99]106,44041,7040%NAChoi b, 2023 Saleh, 2017 20.510.01.0