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

Small for gestational age (weight)

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.
S17121
R71679
Van der Zande - Diuretics, 2024 Small for gestational age (birth weight <10th percentile) during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: Yes Indications Antihypertensive: Only cardiac indications other than hypertension (long QT syndrome, structural heart disease, ...) 1.35 [0.97;1.89] 57/382   527/5,357 584 382
ref
S13924
R54508
Fisher b - Diuretics (Controls unexposed, disease free), 2018 Small for gestational age (birthweight < 10th percentile for a given gestational age in weeks, sex, race/ethnicity, and parity) during pregnancy (anytime or not specified) retrospective cohort unexposed, disease free excluded Adjustment: No Indications Antihypertensive: All hypertensions, any indications or not specified 2.47 [0.45;9.18]
excluded (control group)
3/15   923/10,050 926 15
ref
S13925
R54509
Fisher b - Diuretics (Controls unexposed, sick), 2018 Small for gestational age (birthweight < 10th percentile for a given gestational age in weeks, sex, race/ethnicity, and parity) during pregnancy (anytime or not specified) retrospective cohort unexposed, sick Adjustment: No Indications Antihypertensive: All hypertensions, any indications or not specified 1.83 [0.51;6.58] C 3/15   101/839 104 15
ref
S13447
R51806
Su - Diuretics (Controls unexposed, disease free), 2013 Small for gestational age (<10th percentile for gestational age and gender) during pregnancy (anytime or not specified) population based cohort retrospective unexposed, disease free excluded Adjustment: No Indications Antihypertensive: Only chronic hypertension indication 1.11 [0.84;1.47] C
excluded (control group)
62/371   1,250/8,181 1,312 371
ref
S18078
R76128
Su - Diuretics (Controls unexposed, sick), 2013 Small for gestational age (<10th percentile for gestational age and gender) during pregnancy (anytime or not specified) population based cohort retrospective unexposed, sick Adjustment: Yes Indications Antihypertensive: Only chronic hypertension indication 0.89 [0.65;1.22] 62/371   184/1,006 246 371
ref
S13473
R51970
Nakhai-Pour - Diuretics, 2010 Small for gestational age (a birth weight less than the 10th percentile for that gestational age and gender) 2nd and/or 3rd trimester nested case control unexposed (general population or NOS) Adjustment: No Indications Antihypertensive: All hypertensions, any indications or not specified 1.88 [0.39;9.03] C 2/9   7,443/56,325 7,445 9
ref
S13514
R52204
Mabie - Hydrochlorothiazide, 1986 Intra-uterine growth retardation (birthweight < 10th percentile according to Lubchenco curve) during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No Indications Antihypertensive: Only chronic hypertension indication 2.17 [0.22;21.55] C 1/10   4/82 5 10
ref
Total 5 studies 1.14 [0.87;1.48] 8,384 787
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 - Diuretics, 2024Van der Zande - Diuretics, 2024 1.35[0.97; 1.89]58438244%ROB confusion: seriousROB selection: lowROB classification: unclearROB missing: unclearROB mesure: moderateROB reporting: moderate Fisher b - Diuretics (Controls unexposed, sick), 2018Fisher b - Diuretics, 2018 1 1.83[0.51; 6.58]104154%ROB confusion: criticalROB selection: criticalROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Su - Diuretics (Controls unexposed, sick), 2013Su - Diuretics, 2013 2 0.89[0.65; 1.22]24637148%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Nakhai-Pour - Diuretics, 2010Nakhai-Pour - Diuretics, 2010 1.88[0.39; 9.03]7,44593%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Mabie - Hydrochlorothiazide, 1986Mabie - Hydrochlorothiazide, 1986 2.17[0.22; 21.55]5101%ROB confusion: criticalROB selection: moderateROB classification: unclearROB missing: unclearROB mesure: moderateROB reporting: moderate Total (5 studies) I2 = 12% 1.14[0.87; 1.48]8,3847870.25.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, sick; 2: Controls unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.14[0.83; 1.55]93977827%NAVan der Zande - Diuretics, 2024 Fisher b - Diuretics (Controls unexposed, sick), 2018 Su - Diuretics (Controls unexposed, sick), 2013 Mabie - Hydrochlorothiazide, 1986 4 case control studiescase control studies 1.88[0.39; 9.03]7,4459 -NANakhai-Pour - Diuretics, 2010 1 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.88[0.39; 9.03]7,4459 -NANakhai-Pour - Diuretics, 2010 1 unexposed, sickunexposed, sick 1.14[0.83; 1.55]93977827%NAVan der Zande - Diuretics, 2024 Fisher b - Diuretics (Controls unexposed, sick), 2018 Su - Diuretics (Controls unexposed, sick), 2013 Mabie - Hydrochlorothiazide, 1986 4 Tags Adjustment   - No  - No 1.89[0.76; 4.71]7,554340%NAFisher b - Diuretics (Controls unexposed, sick), 2018 Nakhai-Pour - Diuretics, 2010 Mabie - Hydrochlorothiazide, 1986 3   - Yes  - Yes 1.09[0.73; 1.64]83075368%NAVan der Zande - Diuretics, 2024 Su - Diuretics (Controls unexposed, sick), 2013 2 Indications Antihypertensive   - All hypertensions, any indications ...  - All hypertensions, any indications or not specified 1.85[0.68; 4.99]7,549240%NAFisher b - Diuretics (Controls unexposed, sick), 2018 Nakhai-Pour - Diuretics, 2010 2   - Only cardiac indications other than ...  - Only cardiac indications other than hypertension (long QT syndrome, structural heart disease, ...) 1.35[0.97; 1.88]584382 -NAVan der Zande - Diuretics, 2024 1   - Only chronic hypertension indication  - Only chronic hypertension indication 0.90[0.66; 1.24]2513810%NASu - Diuretics (Controls unexposed, sick), 2013 Mabie - Hydrochlorothiazide, 1986 2 All studiesAll studies 1.14[0.87; 1.48]8,38478712%NAVan der Zande - Diuretics, 2024 Fisher b - Diuretics (Controls unexposed, sick), 2018 Su - Diuretics (Controls unexposed, sick), 2013 Nakhai-Pour - Diuretics, 2010 Mabie - Hydrochlorothiazide, 1986 50.25.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-2.82.91.4070.000Van der Zande - Diuretics, 2024Fisher b - Diuretics (Controls unexposed, sick), 2018Su - Diuretics (Controls unexposed, sick), 2013Nakhai-Pour - Diuretics, 2010Mabie - Hydrochlorothiazide, 1986

Asymetry test p-value = 0.3205 (by Egger's regression)

slope=-0.0673 (0.1904); intercept=0.8924 (0.7516); t=1.1874; p=0.3205

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 13447, 13924

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.16[0.88; 1.52]9,6833950%NAFisher b - Diuretics (Controls unexposed, disease free), 2018 Su - Diuretics (Controls unexposed, disease free), 2013 Nakhai-Pour - Diuretics, 2010 3 unexposed, sick controlsunexposed, sick controls 1.14[0.83; 1.55]93977827%NAVan der Zande - Diuretics, 2024 Fisher b - Diuretics (Controls unexposed, sick), 2018 Su - Diuretics (Controls unexposed, sick), 2013 Mabie - Hydrochlorothiazide, 1986 40.510.01.0

Umbrella review (other published meta-analyses)

Published MAControlPeriodTE95% CIn exposedkI2 Bellos - Furosemide (Small for gestational ag ...Bellos - Furosemide (Small for gestational age (Randomized controlled trial and Cohort studies)) Out of scale0.43[0.04; 5.17]NA-U,Sunexposed, sickAnyduring pregnancy (anytime or not specified)studies TTT-9 Bellos - Furosemide (Small-for-gestational ag ...Bellos - Furosemide (Small-for-gestational age (Randomized controlled trial only)) 0.90[0.05; 15.47]NA-U,Sunexposed, sickAnyduring pregnancy (anytime or not specified)studies TTT-9 metaPregmetaPreg 1.14[0.87; 1.48]12%787----Van der Zande - Diuretics, 2024 Fisher b - Diuretics (Controls unexposed, sick), 2018 Su - Diuretics (Controls unexposed, sick), 2013 Nakhai-Pour - Diuretics, 2010 Mabie - Hydrochlorothiazide, 1986 50.510.01.0