Hydroxychloroquine (All indications except Antiphospholipid Syndrom)

Low birth weight (< 2500g)

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.
S13666
R53067		 Reynolds, 2022 Low birth weight (<2.5 kg) throughout pregnancy retrospective cohort unexposed, sick Adjustment: No Indication HCQ: Systemic lupus erythematosus (SLE) 1.24 [0.58;2.66] 39/146   31/130 70 146
ref
S13670
R53108		 Tang, 2022 Low birth weight (< 2500 g) during pregnancy (anytime or not specified) retrospective cohort unexposed, sick Adjustment: No Indication HCQ: IgA nephropathy 1.84 [0.62;5.46] C 7/25   11/63 18 25
ref
S13645
R52899		 Bérard, 2021 Low birth weight (birthweight < 2,500g) during pregnancy (anytime or not specified) nested case control unexposed (general population or NOS) Adjustment: Yes Indication HCQ: Any or not specified 1.22 [0.57;2.62] 13/103   11,593/230,972 11,606 103
ref
S13697
R53285		 Louthrenoo, 2021 Low birth weight during pregnancy (anytime or not specified) retrospective cohort unexposed, sick Adjustment: No Indication HCQ: Systemic lupus erythematosus (SLE) 0.60 [0.21;1.70] 16/35   21/36 37 35
ref
S13687
R53202		 Leroux, 2015 Intrauterine growth restriction (body weight < 10th percentile) at birth throughout pregnancy retrospective cohort unexposed, sick Adjustment: No Indication HCQ: Systemic lupus erythematosus (SLE) 0.29 [0.09;0.93] C 4/38   22/77 26 38
ref
Total 5 studies 0.93 [0.53;1.61] 11,757 347
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 Reynolds, 2022Reynolds, 2022 1.24[0.58; 2.66]7014625%ROB confusion: criticalROB selection: unclearROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Tang, 2022Tang, 2022 1.84[0.62; 5.46]182517%ROB confusion: criticalROB selection: unclearROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Bérard, 2021Bérard, 2021 1.22[0.57; 2.62]11,60610325%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Louthrenoo, 2021Louthrenoo, 2021 0.60[0.21; 1.70]373518%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Leroux, 2015Leroux, 2015 0.29[0.09; 0.93]263816%ROB confusion: criticalROB selection: criticalROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Total (5 studies) I2 = 43% 0.93[0.53; 1.61]11,7573470.25.01.0ROB: 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 0.83[0.40; 1.74]15124454%NAReynolds, 2022 Tang, 2022 Louthrenoo, 2021 Leroux, 2015 4 case control studiescase control studies 1.22[0.57; 2.62]11,606103 -NABérard, 2021 1 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.22[0.57; 2.62]11,606103 -NABérard, 2021 1 unexposed, sickunexposed, sick 0.83[0.40; 1.74]15124454%NAReynolds, 2022 Tang, 2022 Louthrenoo, 2021 Leroux, 2015 4 Tags Adjustment   - No  - No 0.83[0.40; 1.74]15124454%NAReynolds, 2022 Tang, 2022 Louthrenoo, 2021 Leroux, 2015 4   - Yes  - Yes 1.22[0.57; 2.62]11,606103 -NABérard, 2021 1 Indication HCQ   - Any or not specified  - Any or not specified 1.22[0.57; 2.62]11,606103 -NABérard, 2021 1   - IgA nephropathy  - IgA nephropathy 1.84[0.62; 5.46]1825 -NATang, 2022 1   - Systemic lupus erythematosus (SLE)  - Systemic lupus erythematosus (SLE) 0.66[0.29; 1.51]13321954%NAReynolds, 2022 Louthrenoo, 2021 Leroux, 2015 3 All studiesAll studies 0.93[0.53; 1.61]11,75734743%NAReynolds, 2022 Tang, 2022 Bérard, 2021 Louthrenoo, 2021 Leroux, 2015 50.15.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-1.51.50.7030.000Reynolds, 2022Tang, 2022Bérard, 2021Louthrenoo, 2021Leroux, 2015

Asymetry test p-value = 0.3371 (by Egger's regression)

slope=1.6462 (1.4941); intercept=-3.6415 (3.1942); t=1.1400; p=0.3371

p values plot
0.01.00.01.0

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) 1.22[0.57; 2.62]11,606103 -NABérard, 2021 1 unexposed, sick controlsunexposed, sick controls 0.83[0.40; 1.74]15124454%NAReynolds, 2022 Tang, 2022 Louthrenoo, 2021 Leroux, 2015 40.510.01.0

Umbrella review (other published meta-analyses)

Published MATE95% CIn exposedkI2Control groupExposition period Duan (SLE indication)Duan (SLE indication) 0.77[0.43; 1.39]38%-unexposed, sickthroughout pregnancystudies5 Guillotin (SLE indication)Guillotin (SLE indication) 0.62[0.24; 1.64]66%-whatever (meta-analysis)throughout pregnancystudies5 Kaplan (All indications)Kaplan (All indications) 0.69[0.21; 2.27]72%-whatever (meta-analysis)at least 1st trimesterstudies2 metaPregmetaPreg 0.93[0.53; 1.61]43%347--Reynolds, 2022 Tang, 2022 Bérard, 2021 Louthrenoo, 2021 Leroux, 2015 50.510.01.0