TNF-alpha inhibitors

Maternal consequences (as a whole)

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.
S3093
R4774		 Luu, 2018 Maternal complications (at least 1 complication) 3rd trimester retrospective cohort (claims database) exposed to other treatment, sick 3rd trimester exposure Adjustment: Yes 1.66 [1.40;1.95] -/1,073   -/7,523 - 1,073
ref
S4898
R12943		 Zbinden (rheumatoid arthritis), 2018 Pregnancy complications (preeclampsia, gestational diabetes, infection, preterm premature rupture of membranes) during pregnancy (anytime or not specified) prospective cohort unexposed, disease free Adjustment: No 1.00 [0.23;4.51] -/28   -/70 - 28
ref
S4899
R12947		 Zbinden b (axial spondyloarthritis), 2018 Pregnancy complications (preeclampsia, gestational diabetes, infection, preterm premature rupture of membranes) during pregnancy (anytime or not specified) prospective cohort unexposed, disease free excluded Adjustment: No 3.50 [1.00;12.12]
excluded (control group) 		-/31   -/70 - 31
ref
S3009
R4303		 Hoxha, 2017 Maternal complication 1st trimester prospective cohort unexposed, sick Adjustment: No 4.85 [0.24;98.97] C 4/24   0/11 4 24
ref
Total 3 studies 1.66 [1.40;1.95] 4 1,125
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 Luu, 2018Luu, 2018 1.66[1.40; 1.95]-1,07398%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Zbinden (rheumatoid arthritis), 2018Zbinden, 2018 1 1.00[0.23; 4.51]-281%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Hoxha, 2017Hoxha, 2017 4.85[0.24; 98.97]4240%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (3 studies) I2 = 0% 1.66[1.40; 1.95]41,1250.510.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: rheumatoid arthritis;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.66[1.40; 1.95]41,1250%criticalLuu, 2018 Zbinden (rheumatoid arthritis), 2018 Hoxha, 2017 3 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.00[0.23; 4.43]-28 -criticalZbinden (rheumatoid arthritis), 2018 1 unexposed, sickunexposed, sick 4.85[0.24; 98.97]424 -criticalHoxha, 2017 1 exposed to other treatment, sickexposed to other treatment, sick 1.66[1.41; 1.96]-1,073 -criticalLuu, 2018 1 Tags 3rd trimester exposure3rd trimester exposure 1.66[1.41; 1.96]-1,073 -criticalLuu, 2018 1 Adjustment   - No  - No 1.36[0.36; 5.17]4520%criticalZbinden (rheumatoid arthritis), 2018 Hoxha, 2017 2   - Yes  - Yes 1.66[1.41; 1.96]-1,073 -criticalLuu, 2018 1 All studiesAll studies 1.66[1.40; 1.95]41,1250%criticalLuu, 2018 Zbinden (rheumatoid arthritis), 2018 Hoxha, 2017 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 4899

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 2.00[0.59; 6.79]-5937%NAZbinden (rheumatoid arthritis), 2018 Zbinden b (axial spondyloarthritis), 2018 2 unexposed, sick controlsunexposed, sick controls 4.85[0.24; 98.97]424 -NAHoxha, 2017 1 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.66[1.41; 1.96]-1,073 -NALuu, 2018 10.510.01.0