Thiopurines (Azathioprine, Mercaptopurin) updated on 07-28-2025

Neonatal medical care

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.
S18477
R78398		 Yeaman (Controls mainly exposed to biologics), 2023 Need for admission to the neonatal intensive care unit during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No Indications: Inflammatory Bowel disease (IBD) 0.47 [0.09;2.38] C
excluded (control group) 		2/19   10/50 12 19
ref
S18487
R78407		 Yeaman (Controls unexposed, disease free), 2023 Need for admission to the neonatal intensive care unit during pregnancy (anytime or not specified) prospective cohort unexposed, disease free Adjustment: No Indications: Inflammatory Bowel disease (IBD) 0.43 [0.08;2.25] C 2/19   8/37 10 19
ref
S12218
R53496		 Mahadevan, 2021 Neonatal intensive care unit (NICU) at birth 3 months (or more) before pregnancy or during pregnancy excluded prospective cohort unexposed, sick Adjustment: Yes Indications: Inflammatory Bowel disease (IBD) 1.20 [0.60;2.20]
excluded (exposition period) 		-/242   -/379 - 242
ref
S12241
R46216		 Koslowsky, 2019 Late hospital discharge (delay of discharge for over 48 h) throughout pregnancy prospective cohort unexposed, sick Adjustment: No Indications: Inflammatory Bowel disease (IBD) 8.87 [0.45;176.31] C 5/21   0/13 5 21
ref
S10792
R52300		 Casanova, 2013 Intensive care unit admission 3 months (or more) before pregnancy or during pregnancy excluded retrospective cohort exposed to other treatment, sick Adjustment: No Indications: Inflammatory Bowel disease (IBD) 0.42 [0.09;1.99] C
excluded (exposition period) 		2/187   8/318 10 187
ref
S8433
R27109		 Shim, 2011 Neonatal adverse outcomes (outcomes necessitating admission to neonatal intensive care unit) throughout pregnancy retrospective cohort unexposed, sick Adjustment: No Indications: Inflammatory Bowel disease (IBD) Matched 0.97 [0.10;9.23] 1/19   4/74 5 19
ref
Total 3 studies 1.07 [0.22;5.15] 20 59
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 Yeaman (Controls unexposed, disease free), 2023Yeaman, 2023 1 0.43[0.08; 2.25]101946%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: unclearROB mesure: lowROB reporting: moderate Koslowsky, 2019Koslowsky, 2019 8.87[0.45; 176.31]52122%ROB confusion: criticalROB selection: criticalROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Shim, 2011Shim, 2011 0.97[0.10; 9.23]51932%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Total (3 studies) I2 = 34% 1.07[0.22; 5.15]20590.220.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, disease free;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.07[0.22; 5.15]205934%NAYeaman (Controls unexposed, disease free), 2023 Koslowsky, 2019 Shim, 2011 3 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 0.43[0.08; 2.25]1019 -NAYeaman (Controls unexposed, disease free), 2023 1 unexposed, sickunexposed, sick 2.34[0.28; 19.60]104025%NAKoslowsky, 2019 Shim, 2011 2 Tags Adjustment   - No  - No 1.07[0.22; 5.15]205934%NAYeaman (Controls unexposed, disease free), 2023 Koslowsky, 2019 Shim, 2011 3 Indications   - Inflammatory Bowel disease (IBD)  - Inflammatory Bowel disease (IBD) 1.07[0.22; 5.15]205934%NAYeaman (Controls unexposed, disease free), 2023 Koslowsky, 2019 Shim, 2011 3 MatchedMatched 0.97[0.10; 9.32]519 -NAShim, 2011 1 All studiesAll studies 1.07[0.22; 5.15]205934%NAYeaman (Controls unexposed, disease free), 2023 Koslowsky, 2019 Shim, 2011 30.220.01.0

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 18477

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) Out of scale0.43[0.08; 2.25]1019 -NAYeaman (Controls unexposed, disease free), 2023 1 unexposed, sick controlsunexposed, sick controls 2.34[0.28; 19.60]104025%NAKoslowsky, 2019 Shim, 2011 2 exposed to other treatment, sick controlsexposed to other treatment, sick controls Out of scale0.47[0.09; 2.38]1219 -NAYeaman (Controls mainly exposed to biologics), 2023 10.510.01.0