Mirtazapine updated on 07-01-2025

Low Apgar score (< 7) (at 5 min)

id	Study   Auto Lee (Controls exposed to SSRI), 2025Lee (Controls unexposed, general pop), 2025Martin, 2024	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 R78321	Lee (Controls exposed to SSRI), 2025	5-minute Apgar score<7	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, ...)	3.84 [0.44;33.30] C excluded (control group)	1/77   5/1,465	6	77		ref
S18417 R77890	Lee (Controls unexposed, general pop), 2025	5-minute Apgar score<7	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, ...)	2.18 [0.30;15.93]	1/77   1,721/463,440	1,722	77		ref
S18309 R77106	Martin, 2024	Low Apgar score at 5 min (<7)	during pregnancy (anytime or not specified)	population based cohort retrospective	unexposed (general population or NOS)	Adjustment: Yes Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...)	1.09 [0.79;1.49]	43/2,232   30,996/2,078,011	31,039	2,232		ref
					Total	2 studies	1.11 [0.81;1.52]		32,761	2,309
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 18444

Umbrella review (other published meta-analyses)