Methotrexate (Pre-conception only)

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.
S10377
R38127		 Howren, 2020 Small for gestational age (less than the 10th percentile of gestational age- and sex-specific weights) preconceptional for kinetic reason retrospective cohort unexposed, sick Adjustment: Yes Exposed group: MTX (polytherapy or not specified) Indications: Inflammatory diseases MTX less than 3 months before pregnancy 1.11 [0.31;3.97] -/-   -/6,064 - -
ref
S7243
R21022		 Svirsky, 2009 Fetus small for gestational age (SGA) (NOS) preconceptional for kinetic reason retrospective cohort unexposed, sick Adjustment: No Exposed group: MTX (monotherapy) MTX more than 3 months before pregnancy MTX treatment for ectopic pregnancy 0.34 [0.04;3.01] C 1/45   5/80 6 45
ref
Total 2 studies 0.82 [0.27;2.47] 6 45
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 Howren, 2020Howren, 2020 1.11[0.31; 3.97]--74%ROB confusion: seriousROB selection: moderateROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Svirsky, 2009Svirsky, 2009 0.34[0.04; 3.01]64526%ROB confusion: criticalROB selection: criticalROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Total (2 studies) I2 = 0% 0.82[0.27; 2.47]6450.25.01.0ROB: 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 0.82[0.27; 2.47]6450%NAHowren, 2020 Svirsky, 2009 2 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 0.82[0.27; 2.47]6450%NAHowren, 2020 Svirsky, 2009 2 Tags Adjustment   - No  - No 0.34[0.04; 3.01]645 -NASvirsky, 2009 1   - Yes  - Yes 1.11[0.31; 3.97]-- -NAHowren, 2020 1 Exposed group   - MTX (monotherapy)  - MTX (monotherapy) 0.34[0.04; 3.01]645 -NASvirsky, 2009 1   - MTX (polytherapy or not specified)  - MTX (polytherapy or not specified) 1.11[0.31; 3.97]-- -NAHowren, 2020 1 Indications   - Inflammatory diseases  - Inflammatory diseases 1.11[0.31; 3.97]-- -NAHowren, 2020 1 MTX less than 3 months before pregnancyMTX less than 3 months before pregnancy 1.11[0.31; 3.97]-- -NAHowren, 2020 1 MTX more than 3 months before pregnancyMTX more than 3 months before pregnancy 0.34[0.04; 3.01]645 -NASvirsky, 2009 1 MTX treatment for ectopic pregnancyMTX treatment for ectopic pregnancy 0.34[0.04; 3.01]645 -NASvirsky, 2009 1 All studiesAll studies 0.82[0.27; 2.47]6450%NAHowren, 2020 Svirsky, 2009 20.15.01.0

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, sick controlsunexposed, sick controls 0.82[0.27; 2.47]6450%NAHowren, 2020 Svirsky, 2009 20.510.01.0