Triptans

Preterm (< 37 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
R6902		 Spielmann (Control mainly exposed other treatments, sick), 2017 Preterm (<37 weeks) during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: Yes 1.30 [0.70;2.50]
excluded (control group) 		37/364   43/426 80 364
ref
S3509
R6878		 Spielmann (Control unexposed, disease free), 2017 Preterm (<37 weeks) during pregnancy (anytime or not specified) prospective cohort unexposed, disease free Adjustment: Yes 1.01 [0.70;1.50] 37/364   155/1,518 192 364
ref
S3535
R6995		 Wood 2016a (Control exposed only before pregnancy), 2016 Preterm during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No 0.87 [0.48;1.58] C 16/396   37/798 53 396
ref
S3539
R7011		 Wood 2016a (Control mainly exposed to other treatments, sick), 2016 Preterm during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: Yes 0.83 [0.49;1.41] C
excluded (control group) 		16/396   158/3,291 174 396
ref
S3538
R7002		 Wood 2016a (Control unexposed, disease free), 2016 Preterm during pregnancy (anytime or not specified) prospective cohort unexposed, disease free excluded Adjustment: No 0.87 [0.53;1.44] C
excluded (control group) 		16/396   1,688/36,688 1,704 396
ref
S3492
R6768		 Nezvalová-Henriksen (Control unexposed, disease free), 2013 Gestational age < 37 weeks during pregnancy (anytime or not specified) population based cohort retrospective unexposed, disease free excluded Adjustment: Yes 0.78 [0.63;0.96]
excluded (control group) 		92/1,465   13,013/178,565 13,105 1,465
ref
S851
R6751		 Nezvalová-Henriksen (Control unexposed, sick), 2013 Gestational age < 37 weeks during pregnancy (anytime or not specified) population based cohort retrospective unexposed, sick Adjustment: No 0.61 [0.46;0.82] C 92/1,465   108/1,095 200 1,465
ref
S850
R6552		 Bérard, 2012 Prematurity (<37 weeks of gestation) during pregnancy (anytime or not specified) nested case control unexposed, disease free Adjustment: Yes 0.76 [0.34;1.66] 7/139   3,934/59,568 3,941 139
ref
S849
R6806		 Källén (control unexposed, disease free), 2011 Preterm births (<37 wk) 2nd and/or 3rd trimester population based cohort propective unexposed, disease free Adjustment: No 1.31 [1.03;1.67] 72/-   -/- - -
ref
S3597
R7311		 Olesen - Sumatriptan (Control unexposed, disease free), 2000 Preterm delivery (< 37 weeks) during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, disease free excluded Adjustment: Yes 3.30 [1.30;8.50]
excluded (control group) 		5/34   950/15,995 955 34
ref
S3598
R7313		 Olesen - Sumatriptan (Control unexposed, sick), 2000 Preterm delivery (< 37 weeks) during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, sick Adjustment: Yes 6.30 [1.20;32.00] 5/34   3/89 8 34
ref
S3595
R7304		 Shuhaiber - Sumatriptan (Control exposed to other treatments), 1998 Gestational age < 37 during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: No 0.50 [0.20;1.24] C
excluded (control group) 		8/82   16/90 24 82
ref
S3596
R7308		 Shuhaiber - Sumatriptan (Control unexposed, disease free), 1998 Gestational age < 37 during pregnancy (anytime or not specified) prospective cohort unexposed, disease free Adjustment: No 1.86 [0.58;5.93] C 8/82   5/91 13 82
ref
Total 7 studies 1.03 [0.71;1.48] 4,407 2,480
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 1.01[0.70; 1.50]19236419%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Wood 2016a (Control exposed only before pregnancy), 2016Wood 2016a, 2016 2 0.87[0.48; 1.58]5339615%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Nezvalová-Henriksen (Control unexposed, sick), 2013Nezvalová-Henriksen, 2013 3 0.61[0.46; 0.82]2001,46521%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Bérard, 2012Bérard, 2012 0.76[0.34; 1.66]3,94113911%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Källén (control unexposed, disease free), 2011Källén, 2011 4 1.31[1.03; 1.67]--22%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Olesen - Sumatriptan (Control unexposed, sick), 2000Olesen - Sumatriptan, 2000 5 6.30[1.20; 32.00]8344%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Shuhaiber - Sumatriptan (Control unexposed, disease free), 1998Shuhaiber - Sumatriptan, 1998 6 1.86[0.58; 5.93]13827%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (7 studies) I2 = 73% 1.03[0.71; 1.48]4,4072,4800.220.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Control unexposed, disease free; 2: Control exposed only before pregnancy; 3: Control unexposed, sick; 4: control unexposed, disease free; 5: Control unexposed, sick; 6: Control unexposed, disease free;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.07[0.72; 1.61]4662,34177%NASpielmann (Control unexposed, disease free), 2017 Wood 2016a (Control exposed only before pregnancy), 2016 Nezvalová-Henriksen (Control unexposed, sick), 2013 Källén (control unexposed, disease free), 2011 Olesen - Sumatriptan (Control unexposed, sick), 2000 Shuhaiber - Sumatriptan (Control unexposed, disease free), 1998 6 case control studiescase control studies 0.76[0.34; 1.68]3,941139 -NABérard, 2012 1 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.19[0.97; 1.46]4,1465854%NASpielmann (Control unexposed, disease free), 2017 Bérard, 2012 Källén (control unexposed, disease free), 2011 Shuhaiber - Sumatriptan (Control unexposed, disease free), 1998 4 unexposed, sickunexposed, sick 1.00[0.46; 2.17]2611,89576%NAWood 2016a (Control exposed only before pregnancy), 2016 Nezvalová-Henriksen (Control unexposed, sick), 2013 Olesen - Sumatriptan (Control unexposed, sick), 2000 3 Tags Adjustment   - No  - No 0.98[0.59; 1.62]2661,94382%NAWood 2016a (Control exposed only before pregnancy), 2016 Nezvalová-Henriksen (Control unexposed, sick), 2013 Källén (control unexposed, disease free), 2011 Shuhaiber - Sumatriptan (Control unexposed, disease free), 1998 4   - Yes  - Yes 1.21[0.57; 2.60]4,14153762%NASpielmann (Control unexposed, disease free), 2017 Bérard, 2012 Olesen - Sumatriptan (Control unexposed, sick), 2000 3 All studiesAll studies 1.03[0.71; 1.48]4,4072,48073%NASpielmann (Control unexposed, disease free), 2017 Wood 2016a (Control exposed only before pregnancy), 2016 Nezvalová-Henriksen (Control unexposed, sick), 2013 Bérard, 2012 Källén (control unexposed, disease free), 2011 Olesen - Sumatriptan (Control unexposed, sick), 2000 Shuhaiber - Sumatriptan (Control unexposed, disease free), 1998 70.220.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-2.22.21.0050.000Spielmann (Control unexposed, disease free), 2017Wood 2016a (Control exposed only before pregnancy), 2016Nezvalová-Henriksen (Control unexposed, sick), 2013Bérard, 2012Källén (control unexposed, disease free), 2011Olesen - Sumatriptan (Control unexposed, sick), 2000Shuhaiber - Sumatriptan (Control unexposed, disease free), 1998

Asymetry test p-value = 0.5894 (by Egger's regression)

slope=-0.1767 (0.3164); intercept=0.8691 (1.5082); t=0.5763; p=0.5894

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 3595, 3597, 3492, 3539, 3538, 3510

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.08[0.81; 1.45]19,9732,48067%NASpielmann (Control unexposed, disease free), 2017 Wood 2016a (Control unexposed, disease free), 2016 Nezvalová-Henriksen (Control unexposed, disease free), 2013 Bérard, 2012 Källén (control unexposed, disease free), 2011 Olesen - Sumatriptan (Control unexposed, disease free), 2000 Shuhaiber - Sumatriptan (Control unexposed, disease free), 1998 7 unexposed, sick controlsunexposed, sick controls 1.00[0.46; 2.17]2611,89576%NAWood 2016a (Control exposed only before pregnancy), 2016 Nezvalová-Henriksen (Control unexposed, sick), 2013 Olesen - Sumatriptan (Control unexposed, sick), 2000 3 exposed to other treatment, sick controlsexposed to other treatment, sick controls 0.88[0.55; 1.40]27884233%NASpielmann (Control mainly exposed other treatments, sick), 2017 Wood 2016a (Control mainly exposed to other treatments, sick), 2016 Shuhaiber - Sumatriptan (Control exposed to other treatments), 1998 30.510.01.0