Mirtazapine updated on 07-01-2025

Caesarean

id	Study   Auto Lee (Controls exposed to SSRI), 2025Lee (Controls unexposed, general pop), 2025Gungor (Controls exposed to SSRI), 2019Gungor (Controls unexposed, disease free), 2019Gungor (Controls unexposed, sick), 2019	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.
S18444 R78310	Lee (Controls exposed to SSRI), 2025	Cesarean delivery	during pregnancy (anytime or not specified)	retrospective cohort (claims database)	exposed to other treatment, sick excluded	Adjustment: No Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...)	1.07 [0.66;1.74] C excluded (control group)	26/77   472/1,465	498	77		ref
S18417 R77879	Lee (Controls unexposed, general pop), 2025	Cesarean delivery	during pregnancy (anytime or not specified)	retrospective cohort (claims database)	unexposed (general population or NOS)	Adjustment: Yes Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...)	1.05 [0.65;1.69]	26/77   111,640/463,440	111,666	77		ref
S12919 R49005	Gungor (Controls exposed to SSRI), 2019	Surgical delivery	during pregnancy (anytime or not specified)	prospective cohort	exposed to other treatment, sick excluded	Adjustment: No Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...)	1.00 [0.30;3.31] C excluded (control group)	10/16   25/40	35	16		ref
S12920 R49011	Gungor (Controls unexposed, disease free), 2019	Surgical delivery	during pregnancy (anytime or not specified)	prospective cohort	unexposed, disease free excluded	Adjustment: No Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...)	0.89 [0.24;3.35] C excluded (control group)	10/16   15/23	25	16		ref
S12921 R49017	Gungor (Controls unexposed, sick), 2019	Surgical delivery	during pregnancy (anytime or not specified)	prospective cohort	unexposed, sick	Adjustment: No Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) Unexposed sick: old history of illness/treatment (> 12 months before pregnancy) or not specified	0.73 [0.19;2.80] C	10/16   16/23	26	16		ref
					Total	2 studies	1.01 [0.64;1.58]		111,692	93
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 12919, 12920, 18444