Fluoxetine updated on 07-01-2025

Neural Tube Defects

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.
S7469
R22216		 Anderson, 2020 Any neural tube defect 1st trimester case control unexposed (general population or NOS) Adjustment: Yes Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 1.17 [0.67;2.05] -/-   0/- - -
ref
S7349
R21474		 Wemakor, 2015 Neural tube defects 1st trimester case control unexposed (general population or NOS) Adjustment: Yes Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 0.99 [0.30;3.29] 3/30   1,319/18,375 1,322 30
ref
S6016
R15537		 Jimenez-Solem (Controls unexposed, NOS), 2012 Neural Tube Defects 1st trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes Monotherapy: substance alone among the specific class of antidep (SSRI, SNRI, ...) 3.22 [0.45;23.03] 1/928   -/843,797 - 928
ref
S6242
R16494		 Malm, 2011 Neural tube defects 1st trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes Monotherapy: no or not specified 1.69 [0.62;4.63] -/1,818   -/628,607 - 1,818
ref
S6157
R16127		 Louik, 2007 Neural-tube defects 1st trimester case control unexposed (general population or NOS) Adjustment: No Monotherapy: substance alone among the specific class of antidep (SSRI, SNRI, ...) 0.15 [0.01;2.39] C 0/61   320/6,119 320 61
ref
Total 5 studies 1.22 [0.79;1.89] 1,642 2,837
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 Anderson, 2020Anderson, 2020 1.17[0.67; 2.05]--61%ROB confusion: seriousROB selection: criticalROB classification: criticalROB missing: lowROB mesure: unclearROB reporting: moderate Wemakor, 2015Wemakor, 2015 0.99[0.30; 3.29]1,3223013%ROB confusion: criticalROB selection: criticalROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Jimenez-Solem (Controls unexposed, NOS), 2012Jimenez-Solem, 2012 1 3.22[0.45; 23.03]-9285%ROB confusion: criticalROB selection: moderateROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: critical Malm, 2011Malm, 2011 1.69[0.62; 4.63]-1,81819%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Louik, 2007Louik, 2007 0.15[0.01; 2.39]320612%ROB confusion: moderateROB selection: criticalROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Total (5 studies) I2 = 0% 1.22[0.79; 1.89]1,6422,8370.010.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, NOS;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.93[0.79; 4.73]-2,7460%NAJimenez-Solem (Controls unexposed, NOS), 2012 Malm, 2011 2 case control studiescase control studies 1.05[0.62; 1.78]1,642913%NAAnderson, 2020 Wemakor, 2015 Louik, 2007 3 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.22[0.79; 1.89]1,6422,8370%NAAnderson, 2020 Wemakor, 2015 Jimenez-Solem (Controls unexposed, NOS), 2012 Malm, 2011 Louik, 2007 5 Tags Adjustment   - No  - No 0.15[0.01; 2.39]32061 -NALouik, 2007 1   - Yes  - Yes 1.29[0.83; 2.01]1,3222,7760%NAAnderson, 2020 Wemakor, 2015 Jimenez-Solem (Controls unexposed, NOS), 2012 Malm, 2011 4 Monotherapy   - no or not specified  - no or not specified 1.69[0.62; 4.62]-1,818 -NAMalm, 2011 1   - substance alone among all Antidep ( ...  - substance alone among all Antidep (SSRI, SNRI, ...) 1.14[0.68; 1.88]1,322300%NAAnderson, 2020 Wemakor, 2015 2   - substance alone among the specific ...  - substance alone among the specific class of antidep (SSRI, SNRI, ...) 0.81[0.04; 16.38]32098968%NAJimenez-Solem (Controls unexposed, NOS), 2012 Louik, 2007 2 All studiesAll studies 1.22[0.79; 1.89]1,6422,8370%NAAnderson, 2020 Wemakor, 2015 Jimenez-Solem (Controls unexposed, NOS), 2012 Malm, 2011 Louik, 2007 50.010.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.33.51.7050.000Anderson, 2020Wemakor, 2015Jimenez-Solem (Controls unexposed, NOS), 2012Malm, 2011Louik, 2007

Asymetry test p-value = 0.7526 (by Egger's regression)

slope=0.3527 (0.4964); intercept=-0.3450 (0.9990); t=0.3454; p=0.7526

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[0.79; 1.89]1,6422,8370%NAAnderson, 2020 Wemakor, 2015 Jimenez-Solem (Controls unexposed, NOS), 2012 Malm, 2011 Louik, 2007 50.510.01.0