Diuretics (versus unexposed) updated on 03-11-2025

Major congenital malformations

id	Study   Auto Van der Zande - Diuretics, 2024Van Gelder - Diuretics, 2015Nakhai-Pour - Diuretics, 2010Czeizel - Furosemide, 1999	Lib. in paper	Exposition period  Auto during pregnancy (anytime or not specified)1st trimester2nd trimester3rd trimester2nd and/or 3rd trimesterthroughout pregnancyearly pregnancydays before deliverylate pregnancypreconception-onlypericonceptionalpreconceptional for kinetic reasonat least 1st trimester3 months (or more) before pregnancy or during pregnancy1st and 2nd trimester3 months or more before pregnancy or1st trimester	Study type  All studies Case control excluded Only case control	Control type    Auto unexposed (general population or NOS)unexposed, sickunexposed, disease freeexposed to other treatment, sicknot specifiedsiblingwhatever (meta-analysis)	Tags	OR 95%CI	x1/n1 x0/n0	no cases	no exposed	ROB	Ref.
S17121 R71683	Van der Zande - Diuretics, 2024	Total foetal and neonatal congenital anomalies (composite of the incidence of foetal or neonatal congenital anomalies, that corresponds to major malformations according to the other publication)	1st trimester	prospective cohort	unexposed, sick	Adjustment: Yes Indications Antihypertensive: Only cardiac indications other than hypertension (long QT syndrome, structural heart disease, ...)	1.30 [0.66;2.55]	11/191   276/5,357	287	191		ref
S13806 R54120	Van Gelder - Diuretics, 2015	Selected major birth defects (heart defects, CNS malformations, cleft lip with or without cleft palate, small intestinal atresia/stenosis, hypospadias, ...)	1st trimester	case control	unexposed (general population or NOS)	Adjustment: No Indications Antihypertensive: All hypertensions, any indications or not specified	1.00 [0.50;2.30]	11/25   5,557/12,796	5,568	25		ref
S13473 R51969	Nakhai-Pour - Diuretics, 2010	Major malformations	1st trimester	nested case control	unexposed (general population or NOS)	Adjustment: No Indications Antihypertensive: All hypertensions, any indications or not specified	3.15 [1.19;8.35] C	5/26   4,150/59,007	4,155	26		ref
S17837 R75282	Czeizel - Furosemide, 1999	Congenital malformations	1st trimester	case control	unexposed (general population or NOS)	Adjustment: Yes Indications Antihypertensive: All hypertensions, any indications or not specified Matched	1.60 [0.80;3.30]	14/29   22,851/60,987	22,865	29		ref
					Total	4 studies	1.49 [0.99;2.25]		32,875	271
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

Sensitivity analysis

Publication bias and p-hacking diagnosis

Sub-groups analysis using all included studies

excluded