Triptans

Early intrauterine death (< 22 weeks)

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.
S3510
R6879
Spielmann (Control mainly exposed other treatments, sick), 2017 Spontaneous abortion (<23 weeks of gestation or <500 g) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: Yes 1.41 [0.90;2.20]
excluded (control group)
50/432   37/475 87 432
ref
S3509
R6855
Spielmann (Control unexposed, disease free), 2017 Spontaneous abortion (<23 weeks of gestation or <500 g) during pregnancy (anytime or not specified) prospective cohort unexposed, disease free Adjustment: Yes 1.20 [0.90;1.70] 50/432   159/1,733 209 432
ref
S850
R6548
Bérard, 2012 Spontaneous abortions (anytime between the first day and the 20th week of gestation) during pregnancy (anytime or not specified) nested case control unexposed, disease free Adjustment: Yes 2.65 [1.57;4.48] 21/82   4,748/52,377 4,769 82
ref
S3593
R7289
O'Quinn - Sumatriptan, 1999 Spontaneous abortion (NOS) 1st trimester prospective cohort unexposed, sick Adjustment: No 0.87 [0.33;2.28] C 8/76   11/92 19 76
ref
S3595
R7302
Shuhaiber - Sumatriptan (Control exposed to other treatments), 1998 Spontaneous abortions, miscarriages (NOS) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No 1.94 [0.69;5.48] C
excluded (control group)
11/96   6/96 17 96
ref
S3596
R7306
Shuhaiber - Sumatriptan (Control unexposed, disease free), 1998 Spontaneous abortions, miscarriages (NOS) during pregnancy (anytime or not specified) prospective cohort unexposed, disease free Adjustment: No 2.98 [0.91;9.70] C 11/96   4/96 15 96
ref
Total 4 studies 1.64 [0.94;2.86] 5,012 686
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 Spielmann (Control unexposed, disease free), 2017Spielmann, 2017 1 1.20[0.90; 1.70]20943237%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Bérard, 2012Bérard, 2012 2.65[1.57; 4.48]4,7698230%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA O'Quinn - Sumatriptan, 1999O'Quinn - Sumatriptan, 1999 0.87[0.33; 2.28]197618%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Shuhaiber - Sumatriptan (Control unexposed, disease free), 1998Shuhaiber - Sumatriptan, 1998 2 2.98[0.91; 9.70]159614%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (4 studies) I2 = 66% 1.64[0.94; 2.86]5,0126860.210.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Control unexposed, disease free; 2: Control unexposed, disease free;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.27[0.80; 2.02]24360425%NASpielmann (Control unexposed, disease free), 2017 O'Quinn - Sumatriptan, 1999 Shuhaiber - Sumatriptan (Control unexposed, disease free), 1998 3 case control studiescase control studies 2.65[1.57; 4.48]4,76982 -NABérard, 2012 1 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.91[0.99; 3.69]4,99361074%NASpielmann (Control unexposed, disease free), 2017 Bérard, 2012 Shuhaiber - Sumatriptan (Control unexposed, disease free), 1998 3 unexposed, sickunexposed, sick 0.87[0.33; 2.28]1976 -NAO'Quinn - Sumatriptan, 1999 1 Tags Adjustment   - No  - No 1.53[0.46; 5.11]3417260%NAO'Quinn - Sumatriptan, 1999 Shuhaiber - Sumatriptan (Control unexposed, disease free), 1998 2   - Yes  - Yes 1.73[0.80; 3.76]4,97851484%NASpielmann (Control unexposed, disease free), 2017 Bérard, 2012 2 All studiesAll studies 1.64[0.94; 2.86]5,01268666%NASpielmann (Control unexposed, disease free), 2017 Bérard, 2012 O'Quinn - Sumatriptan, 1999 Shuhaiber - Sumatriptan (Control unexposed, disease free), 1998 40.210.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-1.41.90.7240.000Spielmann (Control unexposed, disease free), 2017Bérard, 2012O'Quinn - Sumatriptan, 1999Shuhaiber - Sumatriptan (Control unexposed, disease free), 1998

Asymetry test p-value = NaN (by Egger's regression)

not enought points

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 3595, 3510

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.91[0.99; 3.69]4,99361074%NASpielmann (Control unexposed, disease free), 2017 Bérard, 2012 Shuhaiber - Sumatriptan (Control unexposed, disease free), 1998 3 unexposed, sick controlsunexposed, sick controls 0.87[0.33; 2.28]1976 -NAO'Quinn - Sumatriptan, 1999 1 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.48[0.98; 2.23]1045280%NASpielmann (Control mainly exposed other treatments, sick), 2017 Shuhaiber - Sumatriptan (Control exposed to other treatments), 1998 20.510.01.0