Tramadol (versus unexposed) updated on 07-09-2025

Digestive system anomalies

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.
S18427
R78025		 Ferrer, 2025 Digestive system anomalies at least 1st trimester retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No 0.89 [0.13;6.39] C 1/999   171/152,811 172 999
ref
S13279
R51129		 Bowie, 2022 Gastrointestinal anomaly at least 1st trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes 2.69 [1.34;5.38] 10/781   2,395/587,676 2,405 781
ref
S13280
R51157		 Sørensen, 2022 Digestive system malformations 1st trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes 0.92 [0.45;1.89] 9/3,796   39/15,111 48 3,796
ref
Total 3 studies 1.46 [0.63;3.39] 2,625 5,576
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 Ferrer, 2025Ferrer, 2025 0.89[0.13; 6.39]17299914%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Bowie, 2022Bowie, 2022 2.69[1.34; 5.38]2,40578143%ROB confusion: moderateROB selection: moderateROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Sørensen, 2022Sørensen, 2022 0.92[0.45; 1.89]483,79643%ROB confusion: moderateROB selection: moderateROB classification: criticalROB missing: moderateROB mesure: moderateROB reporting: moderate Total (3 studies) I2 = 58% 1.46[0.63; 3.39]2,6255,5760.210.01.0ROB: 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 1.46[0.63; 3.39]2,6255,57658%NAFerrer, 2025 Bowie, 2022 Sørensen, 2022 3 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.46[0.63; 3.39]2,6255,57658%NAFerrer, 2025 Bowie, 2022 Sørensen, 2022 3 Tags Adjustment   - No  - No 0.89[0.13; 6.39]172999 -NAFerrer, 2025 1   - Yes  - Yes 1.58[0.55; 4.52]2,4534,57777%NABowie, 2022 Sørensen, 2022 2 All studiesAll studies 1.46[0.63; 3.39]2,6255,57658%NAFerrer, 2025 Bowie, 2022 Sørensen, 2022 30.210.01.0

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) 1.46[0.63; 3.39]2,6255,57658%NAFerrer, 2025 Bowie, 2022 Sørensen, 2022 30.510.01.0