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

Major congenital malformations

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.
S14332
R56700		 Ishikawa (Controls unexposed, disease free), 2023 Major congenital malformations 1st trimester retrospective cohort (claims database) unexposed, disease free excluded Adjustment: No Indications Antihypertensive: Only chronic hypertension indication 1.65 [0.83;3.29] C
excluded (control group) 		9/93   4,519/74,213 4,528 93
ref
S14333
R56702		 Ishikawa (Controls unexposed, sick), 2023 Major congenital malformations 1st trimester retrospective cohort (claims database) unexposed, sick Adjustment: No Indications Antihypertensive: Only chronic hypertension indication 1.41 [0.68;2.93] C 9/93   71/1,007 80 93
ref
S14335
R56711		 Hoeltzenbein, 2017 Major birth defects at least 1st trimester prospective cohort unexposed, disease free Adjustment: Yes Indications Antihypertensive: All hypertensions, any indications or not specified 1.24 [0.40;4.00] 9/246   12/483 21 246
ref
S14366
R56891		 Redman, 1976 Significant congenital abnormalities during pregnancy (anytime or not specified) excluded randomized controlled trial unexposed, sick Adjustment: Randomisation Indications Antihypertensive: All hypertensions, any indications or not specified 1.02 [0.06;16.53] C
excluded (exposition period) 		1/101   1/103 2 101
ref
Total 2 studies 1.36 [0.74;2.52] 101 339
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 Ishikawa (Controls unexposed, sick), 2023Ishikawa, 2023 1 1.41[0.68; 2.93]809371%ROB confusion: criticalROB selection: criticalROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Hoeltzenbein, 2017Hoeltzenbein, 2017 1.24[0.40; 4.00]2124629%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: lowROB mesure: criticalROB reporting: low Total (2 studies) I2 = 0% 1.36[0.74; 2.52]1013390.55.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.36[0.74; 2.52]1013390%NAIshikawa (Controls unexposed, sick), 2023 Hoeltzenbein, 2017 2 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.24[0.39; 3.92]21246 -NAHoeltzenbein, 2017 1 unexposed, sickunexposed, sick 1.41[0.68; 2.93]8093 -NAIshikawa (Controls unexposed, sick), 2023 1 Tags Adjustment   - No  - No 1.41[0.68; 2.93]8093 -NAIshikawa (Controls unexposed, sick), 2023 1   - Yes  - Yes 1.24[0.39; 3.92]21246 -NAHoeltzenbein, 2017 1 Indications Antihypertensive   - All hypertensions, any indications ...  - All hypertensions, any indications or not specified 1.24[0.39; 3.92]21246 -NAHoeltzenbein, 2017 1   - Only chronic hypertension indication  - Only chronic hypertension indication 1.41[0.68; 2.93]8093 -NAIshikawa (Controls unexposed, sick), 2023 1 All studiesAll studies 1.36[0.74; 2.52]1013390%NAIshikawa (Controls unexposed, sick), 2023 Hoeltzenbein, 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 14332

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.53[0.85; 2.77]4,5493390%NAIshikawa (Controls unexposed, disease free), 2023 Hoeltzenbein, 2017 2 unexposed, sick controlsunexposed, sick controls 1.41[0.68; 2.93]8093 -NAIshikawa (Controls unexposed, sick), 2023 10.510.01.0