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

Genital 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
R78028		 Ferrer, 2025 Genital system anomalies at least 1st trimester retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No 0.41 [0.06;2.94] C 1/999   370/152,811 371 999
ref
S13280
R51159		 Sørensen, 2022 External genital organs malformations 1st trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes 0.97 [0.49;1.94] 10/3,796   41/15,111 51 3,796
ref
Total 2 studies 0.88 [0.46;1.69] 422 4,795
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 0.41[0.06; 2.94]37199911%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Sørensen, 2022Sørensen, 2022 0.97[0.49; 1.94]513,79689%ROB confusion: moderateROB selection: moderateROB classification: criticalROB missing: moderateROB mesure: moderateROB reporting: moderate Total (2 studies) I2 = 0% 0.88[0.46; 1.69]4224,7950.22.01.0ROB: 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 0.88[0.46; 1.69]4224,7950%NAFerrer, 2025 Sørensen, 2022 2 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 0.88[0.46; 1.69]4224,7950%NAFerrer, 2025 Sørensen, 2022 2 Tags Adjustment   - No  - No 0.41[0.06; 2.94]371999 -NAFerrer, 2025 1   - Yes  - Yes 0.97[0.49; 1.93]513,796 -NASørensen, 2022 1 All studiesAll studies 0.88[0.46; 1.69]4224,7950%NAFerrer, 2025 Sørensen, 2022 20.210.01.0

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) 0.88[0.46; 1.69]4224,7950%NAFerrer, 2025 Sørensen, 2022 20.510.01.0