Proton Pump Inhibitors updated on 08-09-2023

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.
S14451
R57339		 Breddels, 2022 Small for gestational age (SGA) (birth weight below the 10th population percentile) 2nd trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes 1.06 [0.84;1.33] -/-   -/- - -
ref
S4444
R10524		 Cluver - Esomeprazole, 2018 Growth restriction (estimated fetal weight < 10th percentile) late pregnancy randomized controlled trial unexposed, sick Adjustment: Randomisation 1.81 [0.87;3.77] C 38/59   30/60 68 59
ref
S4861
R12592		 Ruigomez - Omeprazole (Controls exposed to other treatment, sick), 1999 Small for gestational age (birth weight < third percentile) 1st trimester retrospective cohort exposed to other treatment, sick excluded Adjustment: No 0.56 [0.03;12.00] C
excluded (control group) 		0/39   2/111 2 39
ref
S4276
R12494		 Ruigomez - Omeprazole (Controls unexposed NOS), 1999 Small for gestational age (birth weight < third percentile) 1st trimester retrospective cohort unexposed (general population or NOS) Adjustment: No 0.55 [0.03;9.17] C 0/39   21/924 21 39
ref
Total 3 studies 1.12 [0.86;1.46] 89 98
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 1.06[0.84; 1.33]--87%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Cluver - Esomeprazole, 2018Cluver - Esomeprazole, 2018 1.81[0.87; 3.77]685912%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Ruigomez - Omeprazole (Controls unexposed NOS), 1999Ruigomez - Omeprazole, 1999 1 0.55[0.03; 9.17]21391%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (3 studies) I2 = 5% 1.12[0.86; 1.46]89980.25.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed NOS;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.06[0.84; 1.33]21390%NABreddels, 2022 Ruigomez - Omeprazole (Controls unexposed NOS), 1999 2 case control studiescase control studies 0 RCTRCT 1.81[0.87; 3.77]6859 -NACluver - Esomeprazole, 2018 1 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.06[0.84; 1.33]21390%NABreddels, 2022 Ruigomez - Omeprazole (Controls unexposed NOS), 1999 2 unexposed, sickunexposed, sick 1.81[0.87; 3.77]6859 -NACluver - Esomeprazole, 2018 1 Tags Adjustment   - No  - No 0.55[0.03; 9.17]2139 -NARuigomez - Omeprazole (Controls unexposed NOS), 1999 1   - Randomisation  - Randomisation 1.81[0.87; 3.77]6859 -NACluver - Esomeprazole, 2018 1   - Yes  - Yes 1.06[0.84; 1.33]-- -NABreddels, 2022 1 All studiesAll studies 1.12[0.86; 1.46]89985%NABreddels, 2022 Cluver - Esomeprazole, 2018 Ruigomez - Omeprazole (Controls unexposed NOS), 1999 30.25.01.0

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 4861

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.06[0.84; 1.33]21390%NABreddels, 2022 Ruigomez - Omeprazole (Controls unexposed NOS), 1999 2 unexposed, sick controlsunexposed, sick controls 1.81[0.87; 3.77]6859 -NACluver - Esomeprazole, 2018 1 exposed to other treatment, sick controlsexposed to other treatment, sick controls 0.56[0.03; 12.00]239 -NARuigomez - Omeprazole (Controls exposed to other treatment, sick), 1999 10.510.01.0