TNF-alpha inhibitors

Maternal infections

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.
S3066
R4659
Chaparro, 2018 Infections during pregnancy 3 months (or more) before pregnancy or during pregnancy excluded retrospective cohort unexposed, sick Adjustment: No 4.83 [1.60;14.57] C
excluded (exposition period)
16/388   4/453 20 388
ref
S3093
R4775
Luu, 2018 All maternal infections 3rd trimester retrospective cohort (claims database) exposed to other treatment, sick 3rd trimester exposure Adjustment: Yes 1.42 [1.24;1.63] -/1,073   -/7,523 - 1,073
ref
S3075
R4718
Desai, 2017 Serious infections during pregnancy during pregnancy (anytime or not specified) retrospective cohort (claims database) exposed to other treatment, sick Adjustment: Yes All indications 1.36 [0.47;3.93] 8/776   11/816 19 776
ref
Total 2 studies 1.42 [1.24;1.63] 19 1,849
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 1.42[1.24; 1.63]-1,07398%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Desai, 2017Desai, 2017 1.36[0.47; 3.93]197762%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (2 studies) I2 = 0% 1.42[1.24; 1.63]191,8490.55.01.0ROB: 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 1.42[1.24; 1.63]191,8490%criticalLuu, 2018 Desai, 2017 2 case control studiescase control studies 0 Type of controls exposed to other treatment, sickexposed to other treatment, sick 1.42[1.24; 1.63]191,8490%criticalLuu, 2018 Desai, 2017 2 Tags 3rd trimester exposure3rd trimester exposure 1.42[1.24; 1.63]-1,073 -criticalLuu, 2018 1 Adjustment   - Yes  - Yes 1.42[1.24; 1.63]191,8490%criticalLuu, 2018 Desai, 2017 2 All indicationsAll indications 1.36[0.47; 3.93]19776 -criticalDesai, 2017 1 All studiesAll studies 1.42[1.24; 1.63]191,8490%criticalLuu, 2018 Desai, 2017 20.55.01.0

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 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.42[1.24; 1.63]191,8490%NALuu, 2018 Desai, 2017 20.510.01.0