Renin-angiotensin system (ACEIs and/or ARBs) (versus unexposed) updated on 03-11-2025

Therapeutic terminations of pregnancy

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.
S17123
R71688		 Van der Zande - ACE-Is and/or ARBs, 2024 Therapeutic termination of pregnancy (for foetal anomalies) 1st trimester prospective cohort unexposed, sick Adjustment: No Indications Antihypertensive: Only cardiac indications other than hypertension (long QT syndrome, structural heart disease, ...) Renin angiotensin: ARBs and/or ACEIs (Angiotensin II receptor blockers and/or Angiotensin-converting enzyme inhibitors) 5.47 [0.32;93.32] C 0/34   15/5,697 15 34
ref
S14147
R55483		 Hoeltzenbein a - ARBs, 2018 Elective termination of pregnancy for Embryopathology early pregnancy prospective cohort unexposed, disease free Adjustment: No Indications Antihypertensive: Only chronic hypertension indication Matched Renin angiotensin: ARBs (Angiotensin II receptor blockers) 9.42 [0.97;91.10] C 3/189   1/585 4 189
ref
S14146
R55478		 Cournot - ACEi, 2006 Medical terminations of pregnancy 1st trimester prospective cohort unexposed (general population or NOS) Adjustment: No Indications Antihypertensive: All hypertensions, any indications or not specified Matched Renin angiotensin: ACEIs (Angiotensin-converting enzyme inhibitors) 3.08 [0.61;15.49] C 6/159   2/159 8 159
ref
Total 3 studies 4.65 [1.41;15.33] 27 382
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 Van der Zande - ACE-Is and/or ARBs, 2024Van der Zande - ACE-Is and/or ARBs, 2024 5.47[0.32; 93.32]153418%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Hoeltzenbein a - ARBs, 2018Hoeltzenbein a - ARBs, 2018 9.42[0.97; 91.10]418928%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: lowROB mesure: unclearROB reporting: moderate Cournot - ACEi, 2006Cournot - ACEi, 2006 3.08[0.61; 15.49]815955%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: unclearROB reporting: moderate Total (3 studies) I2 = 0% 4.65[1.41; 15.33]273820.920.01.0ROB: 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 4.65[1.41; 15.33]273820%NAVan der Zande - ACE-Is and/or ARBs, 2024 Hoeltzenbein a - ARBs, 2018 Cournot - ACEi, 2006 3 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 4.48[1.20; 16.72]123480%NAHoeltzenbein a - ARBs, 2018 Cournot - ACEi, 2006 2 unexposed, sickunexposed, sick 5.47[0.32; 93.32]1534 -NAVan der Zande - ACE-Is and/or ARBs, 2024 1 Tags Adjustment   - No  - No 4.65[1.41; 15.33]273820%NAVan der Zande - ACE-Is and/or ARBs, 2024 Hoeltzenbein a - ARBs, 2018 Cournot - ACEi, 2006 3 Indications Antihypertensive   - All hypertensions, any indications ...  - All hypertensions, any indications or not specified 3.08[0.61; 15.49]8159 -NACournot - ACEi, 2006 1   - Only cardiac indications other than ...  - Only cardiac indications other than hypertension (long QT syndrome, structural heart disease, ...) 5.47[0.32; 93.32]1534 -NAVan der Zande - ACE-Is and/or ARBs, 2024 1   - Only chronic hypertension indication  - Only chronic hypertension indication 9.42[0.97; 91.10]4189 -NAHoeltzenbein a - ARBs, 2018 1 MatchedMatched 4.48[1.20; 16.72]123480%NAHoeltzenbein a - ARBs, 2018 Cournot - ACEi, 2006 2 Renin angiotensin   - ACEIs (Angiotensin-converting enzym ...  - ACEIs (Angiotensin-converting enzyme inhibitors) 3.08[0.61; 15.49]8159 -NACournot - ACEi, 2006 1   - ARBs (Angiotensin II receptor blockers)  - ARBs (Angiotensin II receptor blockers) 9.42[0.97; 91.10]4189 -NAHoeltzenbein a - ARBs, 2018 1   - ARBs and/or ACEIs (Angiotensin II r ...  - ARBs and/or ACEIs (Angiotensin II receptor blockers and/or Angiotensin-converting enzyme inhibitors) 5.47[0.32; 93.32]1534 -NAVan der Zande - ACE-Is and/or ARBs, 2024 1 All studiesAll studies 4.65[1.41; 15.33]273820%NAVan der Zande - ACE-Is and/or ARBs, 2024 Hoeltzenbein a - ARBs, 2018 Cournot - ACEi, 2006 30.520.01.0

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 controls (disease free or unspecified)unexposed controls (disease free or unspecified) 4.48[1.20; 16.72]123480%NAHoeltzenbein a - ARBs, 2018 Cournot - ACEi, 2006 2 unexposed, sick controlsunexposed, sick controls 5.47[0.32; 93.32]1534 -NAVan der Zande - ACE-Is and/or ARBs, 2024 10.510.01.0