Tricyclic antidepressants updated on 07-01-2025

Low birth weight (< 2500g)

id	Study   Auto Lee (Controls exposed to SSRI), 2025Lee (Controls unexposed, general pop), 2025Reis (Controls exposed to SSRIs), 2010Reis (Controls unexposed, NOS), 2010Pearson (Controls exposed to SSRIs), 2007Simon (Controls exposed to SSRIs), 2002Simon (Controls unexposed, NOS), 2002	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 trimesterPaternal exp. genotoxic window only (0–3 months preconception)Paternal exposure: epigenetic window only (3–xxx months preconception)Paternal exposure: genotoxic/epigenetic window (0–xxx months preconception)Paternal exposure: other window	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.
S18445 R78338	Lee (Controls exposed to SSRI), 2025	Low birth weight (birth weight <2500 g)	during pregnancy (anytime or not specified)	retrospective cohort (claims database)	exposed to other treatment, sick excluded	Adjustment: No Monotherapy: TCA only	1.12 [0.83;1.52] C excluded (control group)	68/613   147/1,465	215	613		ref
S18410 R77739	Lee (Controls unexposed, general pop), 2025	Low birth weight (birth weight <2500 g)	during pregnancy (anytime or not specified)	retrospective cohort (claims database)	unexposed (general population or NOS)	Adjustment: Yes Monotherapy: TCA only	1.10 [0.85;1.42]	68/613   31,347/463,440	31,415	613		ref
S10933 R40664	Reis (Controls exposed to SSRIs), 2010	Low birthweight (<2500 g)	2nd and/or 3rd trimester	population based cohort retrospective	exposed to other treatment, sick excluded	Adjustment: No Monotherapy: TCA only	1.20 [0.84;1.73] C excluded (control group)	37/784   190/4,809	227	784		ref
S10934 R40667	Reis (Controls unexposed, NOS), 2010	Low birthweight (<2500 g)	2nd and/or 3rd trimester	population based cohort retrospective	unexposed (general population or NOS)	Adjustment: Yes Monotherapy: TCA only	1.39 [1.00;1.95]	37/784   37,105/1,062,190	37,142	784		ref
S11218 R41282	Pearson (Controls exposed to SSRIs), 2007	Low birth weight (NOS)	during pregnancy (anytime or not specified)	retrospective cohort	exposed to other treatment, sick	Adjustment: No Monotherapy: TCA only	2.34 [0.20;26.95] C	2/37   1/42	3	37		ref
S10935 R40671	Simon (Controls exposed to SSRIs), 2002	Birth weight <2500 g	during pregnancy (anytime or not specified)	retrospective cohort (claims database)	exposed to other treatment, sick excluded	Adjustment: No Monotherapy: TCA only	0.72 [0.31;1.72] C excluded (control group)	10/209   12/185	22	209		ref
S10936 R40687	Simon (Controls unexposed, NOS), 2002	Birth weight <2500 g	during pregnancy (anytime or not specified)	retrospective cohort (claims database)	unexposed (general population or NOS)	Adjustment: Yes Matched Monotherapy: TCA only	1.18 [0.42;3.28]	10/209   8/209	18	209		ref
					Total	4 studies	1.20 [0.99;1.47]		68,578	1,643
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 10935, 10933, 18445

Umbrella review (other published meta-analyses)