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

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.
S17160
R71970		 Vaclavik - ACEs/ARBs, 2024 Low birth weight during pregnancy (anytime or not specified) population based cohort retrospective unexposed, disease free Adjustment: No Indications Antihypertensive: All hypertensions, any indications or not specified 1.97 [1.38;2.80] -/830   -/66,393 - 830
ref
S14118
R55460		 Chintamaneni - ACE inhibitors, 2018 Low birth weight (<2500g) during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No Indications Antihypertensive: All hypertensions, any indications or not specified Renin angiotensin: ACEIs (Angiotensin-converting enzyme inhibitors) 3.00 [2.27;3.95] C 59/404   20,457/378,834 20,516 404
ref
S14211
R55716		 Colvin - ACEi, 2014 Birth weight <2500 g 1st trimester retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: Yes Indications Antihypertensive: All hypertensions, any indications or not specified Renin angiotensin: ACEIs (Angiotensin-converting enzyme inhibitors) 1.86 [0.79;4.37] 21/84   6,996/97,533 7,017 84
ref
Total 3 studies 2.39 [1.71;3.34] 27,533 1,318
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 Vaclavik - ACEs/ARBs, 2024Vaclavik - ACEs/ARBs, 2024 1.97[1.38; 2.80]-83040%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: unclear Chintamaneni - ACE inhibitors, 2018Chintamaneni - ACE inhibitors, 2018 3.00[2.27; 3.95]20,51640448%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Colvin - ACEi, 2014Colvin - ACEi, 2014 1.86[0.79; 4.37]7,0178413%ROB confusion: seriousROB selection: moderateROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: critical Total (3 studies) I2 = 48% 2.39[1.71; 3.34]27,5331,3180.510.01.0ROB: 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 2.39[1.71; 3.34]27,5331,31848%NAVaclavik - ACEs/ARBs, 2024 Chintamaneni - ACE inhibitors, 2018 Colvin - ACEi, 2014 3 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 2.39[1.71; 3.34]27,5331,31848%NAVaclavik - ACEs/ARBs, 2024 Chintamaneni - ACE inhibitors, 2018 Colvin - ACEi, 2014 3 Tags Adjustment   - No  - No 2.47[1.64; 3.72]20,5161,23470%NAVaclavik - ACEs/ARBs, 2024 Chintamaneni - ACE inhibitors, 2018 2   - Yes  - Yes 1.86[0.79; 4.37]7,01784 -NAColvin - ACEi, 2014 1 Indications Antihypertensive   - All hypertensions, any indications ...  - All hypertensions, any indications or not specified 2.39[1.71; 3.34]27,5331,31848%NAVaclavik - ACEs/ARBs, 2024 Chintamaneni - ACE inhibitors, 2018 Colvin - ACEi, 2014 3 Renin angiotensin   - ACEIs (Angiotensin-converting enzym ...  - ACEIs (Angiotensin-converting enzyme inhibitors) 2.82[2.07; 3.84]27,5334887%NAChintamaneni - ACE inhibitors, 2018 Colvin - ACEi, 2014 2 All studiesAll studies 2.39[1.71; 3.34]27,5331,31848%NAVaclavik - ACEs/ARBs, 2024 Chintamaneni - ACE inhibitors, 2018 Colvin - ACEi, 2014 30.510.01.0

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) 2.39[1.71; 3.34]27,5331,31848%NAVaclavik - ACEs/ARBs, 2024 Chintamaneni - ACE inhibitors, 2018 Colvin - ACEi, 2014 30.510.01.0

Umbrella review (other published meta-analyses)

Published MAControlPeriodTE95% CIn exposedkI2 Buawangpong (ACEi/ARBs) (Low birth weight)Buawangpong (ACEi/ARBs) (Low birth weight) 1.04[0.59; 1.81]NA-Wwhatever (meta-analysis)T11st trimesterstudies TTT1 Buawangpong (ACEi/ARBs) (Low birth weight)Buawangpong (ACEi/ARBs) (Low birth weight) 2.30[1.20; 4.41]85%-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT3 metaPregmetaPreg 2.39[1.71; 3.34]48%1,318----Vaclavik - ACEs/ARBs, 2024 Chintamaneni - ACE inhibitors, 2018 Colvin - ACEi, 2014 30.510.01.0