Tramadol (versus unexposed) updated on 07-09-2025

Oro-facial clefts

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.
S18427
R78024		 Ferrer, 2025 Cleft lip/cleft palate at least 1st trimester retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No 2.10 [0.52;8.48] C 2/999   146/152,811 148 999
ref
S13279
R51135		 Bowie, 2022 Oral clefts at least 1st trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes 1.46 [0.23;9.50] 5/781   610/587,676 615 781
ref
S13280
R51156		 Sørensen, 2022 Oro-facial clefts 1st trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes 0.70 [0.30;1.67] 6/3,796   34/15,111 40 3,796
ref
Total 3 studies 1.00 [0.51;1.98] 803 5,576
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 Ferrer, 2025Ferrer, 2025 2.10[0.52; 8.48]14899924%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Bowie, 2022Bowie, 2022 1.46[0.23; 9.50]61578113%ROB confusion: moderateROB selection: moderateROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Sørensen, 2022Sørensen, 2022 0.70[0.30; 1.67]403,79663%ROB confusion: moderateROB selection: moderateROB classification: criticalROB missing: moderateROB mesure: moderateROB reporting: moderate Total (3 studies) I2 = 0% 1.00[0.51; 1.98]8035,5760.25.01.0ROB: 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 1.00[0.51; 1.98]8035,5760%NAFerrer, 2025 Bowie, 2022 Sørensen, 2022 3 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.00[0.51; 1.98]8035,5760%NAFerrer, 2025 Bowie, 2022 Sørensen, 2022 3 Tags Adjustment   - No  - No 2.10[0.52; 8.48]148999 -NAFerrer, 2025 1   - Yes  - Yes 0.80[0.37; 1.74]6554,5770%NABowie, 2022 Sørensen, 2022 2 All studiesAll studies 1.00[0.51; 1.98]8035,5760%NAFerrer, 2025 Bowie, 2022 Sørensen, 2022 30.25.01.0

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) 1.00[0.51; 1.98]8035,5760%NAFerrer, 2025 Bowie, 2022 Sørensen, 2022 30.510.01.0