Triptans

Low birth weight (< 2500g)

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.
S3535
R6994		 Wood 2016a (Control exposed only before pregnancy), 2016 Low birth weight during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No 0.89 [0.39;2.07] C 8/396   18/798 26 396
ref
S3539
R7010		 Wood 2016a (Control mainly exposed to other treatments, sick), 2016 Low birth weight during pregnancy (anytime or not specified) prospective cohort exposed to other treatment, sick excluded Adjustment: Yes 0.77 [0.37;1.60] C
excluded (control group) 		8/396   86/3,291 94 396
ref
S3538
R7001		 Wood 2016a (Control unexposed, disease free), 2016 Low birth weight during pregnancy (anytime or not specified) prospective cohort unexposed, disease free excluded Adjustment: No 0.84 [0.41;1.69] C
excluded (control group) 		8/396   881/36,688 889 396
ref
S3492
R6765		 Nezvalová-Henriksen (Control unexposed, disease free), 2013 Birth weight < 2,500 g during pregnancy (anytime or not specified) population based cohort retrospective unexposed, disease free excluded Adjustment: Yes 1.17 [0.93;1.49]
excluded (control group) 		75/1,465   7,168/178,565 7,243 1,465
ref
S851
R6748		 Nezvalová-Henriksen (Control unexposed, sick), 2013 Birth weight < 2,500 g during pregnancy (anytime or not specified) population based cohort retrospective unexposed, sick Adjustment: No 0.84 [0.60;1.18] C 75/1,465   66/1,095 141 1,465
ref
S850
R6717		 Bérard, 2012 Low birth weight (LBW) (<2500 g) during pregnancy (anytime or not specified) nested case control unexposed, disease free Adjustment: Yes 0.83 [0.31;2.25] 6/139   3,383/59,568 3,389 139
ref
S3592
R7287		 Kallen - Sumatriptan, 2001 Low birth weight (< 2500 g, singletons) early pregnancy population based cohort retrospective unexposed (general population or NOS) Adjustment: No 1.18 [0.70;1.97] 25/658   -/- - 658
ref
S3597
R7310		 Olesen - Sumatriptan (Control unexposed, disease free), 2000 LBW (< 2500 g) during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, disease free excluded Adjustment: Yes 2.30 [0.30;17.60]
excluded (control group) 		1/34   291/15,995 292 34
ref
S3598
R7312		 Olesen - Sumatriptan (Control unexposed, sick), 2000 LBW (< 2500 g) during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, sick Adjustment: Yes 0.90 [0.10;11.80] 1/34   5/89 6 34
ref
Total 5 studies 0.92 [0.71;1.19] 3,562 2,692
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 Wood 2016a (Control exposed only before pregnancy), 2016Wood 2016a, 2016 1 0.89[0.39; 2.07]263969%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Nezvalová-Henriksen (Control unexposed, sick), 2013Nezvalová-Henriksen, 2013 2 0.84[0.60; 1.18]1411,46558%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Bérard, 2012Bérard, 2012 0.83[0.31; 2.25]3,3891397%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Kallen - Sumatriptan, 2001Kallen - Sumatriptan, 2001 1.18[0.70; 1.97]-65825%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Olesen - Sumatriptan (Control unexposed, sick), 2000Olesen - Sumatriptan, 2000 3 0.90[0.10; 11.80]6341%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (5 studies) I2 = 0% 0.92[0.71; 1.19]3,5622,6920.25.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Control exposed only before pregnancy; 2: Control unexposed, sick; 3: Control unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 0.93[0.71; 1.21]1732,5530%NAWood 2016a (Control exposed only before pregnancy), 2016 Nezvalová-Henriksen (Control unexposed, sick), 2013 Kallen - Sumatriptan, 2001 Olesen - Sumatriptan (Control unexposed, sick), 2000 4 case control studiescase control studies 0.83[0.31; 2.24]3,389139 -NABérard, 2012 1 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.09[0.69; 1.73]3,3897970%NABérard, 2012 Kallen - Sumatriptan, 2001 2 unexposed, sickunexposed, sick 0.85[0.62; 1.16]1731,8950%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 0.93[0.71; 1.21]1672,5190%NAWood 2016a (Control exposed only before pregnancy), 2016 Nezvalová-Henriksen (Control unexposed, sick), 2013 Kallen - Sumatriptan, 2001 3   - Yes  - Yes 0.84[0.34; 2.10]3,3951730%NABérard, 2012 Olesen - Sumatriptan (Control unexposed, sick), 2000 2 All studiesAll studies 0.92[0.71; 1.19]3,5622,6920%NAWood 2016a (Control exposed only before pregnancy), 2016 Nezvalová-Henriksen (Control unexposed, sick), 2013 Bérard, 2012 Kallen - Sumatriptan, 2001 Olesen - Sumatriptan (Control unexposed, sick), 2000 50.25.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-2.92.81.4600.000Wood 2016a (Control exposed only before pregnancy), 2016Nezvalová-Henriksen (Control unexposed, sick), 2013Bérard, 2012Kallen - Sumatriptan, 2001Olesen - Sumatriptan (Control unexposed, sick), 2000

Asymetry test p-value = 0.8652 (by Egger's regression)

slope=-0.1093 (0.1656); intercept=0.1037 (0.5615); t=0.1847; p=0.8652

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 3597, 3492, 3539, 3538

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.13[0.93; 1.38]11,8292,6920%NAWood 2016a (Control unexposed, disease free), 2016 Nezvalová-Henriksen (Control unexposed, disease free), 2013 Bérard, 2012 Kallen - Sumatriptan, 2001 Olesen - Sumatriptan (Control unexposed, disease free), 2000 5 unexposed, sick controlsunexposed, sick controls 0.85[0.62; 1.16]1731,8950%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 0.77[0.37; 1.60]94396 -NAWood 2016a (Control mainly exposed to other treatments, sick), 2016 10.510.01.0