Fluoxetine updated on 07-01-2025

Craniosynostosis

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
R22235		 Anderson, 2020 Craniosynostosis 1st trimester case control unexposed (general population or NOS) Adjustment: Yes Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 1.92 [1.20;3.07] -/-   0/- - -
ref
S7438
R21949		 Bérard, 2017 Craniosynostosis 1st trimester retrospective cohort (claims database) unexposed, sick Adjustment: Yes Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) Unexposed sick: intermediate history of illness/treatment (3-12 months before pregnancy) 1.14 [0.16;8.21] -/191   -/14,847 - 191
ref
S7349
R21457		 Wemakor, 2015 Craniosynostosis 1st trimester case control unexposed (general population or NOS) Adjustment: No Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 4.14 [0.98;17.50] C 2/29   305/17,361 307 29
ref
S6242
R16502		 Malm, 2011 Craniocynostosis 1st trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes Monotherapy: no or not specified 1.12 [0.15;8.16] -/1,818   -/628,607 - 1,818
ref
S6157
R16113		 Louik, 2007 Craniosynostosis 1st trimester case control unexposed (general population or NOS) Adjustment: No Monotherapy: substance alone among the specific class of antidep (SSRI, SNRI, ...) 0.41 [0.03;6.70] C 0/61   115/5,914 115 61
ref
Total 5 studies 1.89 [1.24;2.87] 422 2,099
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 1.92[1.20; 3.07]--80%ROB confusion: seriousROB selection: criticalROB classification: criticalROB missing: lowROB mesure: unclearROB reporting: moderate Bérard, 2017Bérard, 2017 1.14[0.16; 8.21]-1915%ROB confusion: seriousROB selection: moderateROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Wemakor, 2015Wemakor, 2015 4.14[0.98; 17.50]307299%ROB confusion: criticalROB selection: criticalROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Malm, 2011Malm, 2011 1.12[0.15; 8.16]-1,8184%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Louik, 2007Louik, 2007 0.41[0.03; 6.70]115612%ROB confusion: moderateROB selection: criticalROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Total (5 studies) I2 = 0% 1.89[1.24; 2.87]4222,0990.210.01.0ROB: 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 1.13[0.28; 4.59]-2,0090%NABérard, 2017 Malm, 2011 2 case control studiescase control studies 2.02[1.11; 3.66]4229011%NAAnderson, 2020 Wemakor, 2015 Louik, 2007 3 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.93[1.26; 2.97]4221,9080%NAAnderson, 2020 Wemakor, 2015 Malm, 2011 Louik, 2007 4 unexposed, sickunexposed, sick 1.14[0.16; 8.17]-191 -NABérard, 2017 1 Tags Adjustment   - No  - No 1.80[0.21; 15.82]4229052%NAWemakor, 2015 Louik, 2007 2   - Yes  - Yes 1.82[1.17; 2.84]-2,0090%NAAnderson, 2020 Bérard, 2017 Malm, 2011 3 Monotherapy   - no or not specified  - no or not specified 1.12[0.15; 8.26]-1,818 -NAMalm, 2011 1   - substance alone among all Antidep ( ...  - substance alone among all Antidep (SSRI, SNRI, ...) 2.01[1.30; 3.10]3072200%NAAnderson, 2020 Bérard, 2017 Wemakor, 2015 3   - substance alone among the specific ...  - substance alone among the specific class of antidep (SSRI, SNRI, ...) 0.41[0.03; 6.70]11561 -NALouik, 2007 1 Unexposed sick   - intermediate history of illness/tre ...  - intermediate history of illness/treatment (3-12 months before pregnancy) 1.14[0.16; 8.17]-191 -NABérard, 2017 1 All studiesAll studies 1.89[1.24; 2.87]4222,0990%NAAnderson, 2020 Bérard, 2017 Wemakor, 2015 Malm, 2011 Louik, 2007 50.210.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.34.01.7080.000Anderson, 2020Bérard, 2017Wemakor, 2015Malm, 2011Louik, 2007

Asymetry test p-value = 0.4943 (by Egger's regression)

slope=0.8235 (0.3079); intercept=-0.4978 (0.6415); t=0.7760; p=0.4943

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) 1.93[1.26; 2.97]4221,9080%NAAnderson, 2020 Wemakor, 2015 Malm, 2011 Louik, 2007 4 unexposed, sick controlsunexposed, sick controls 1.14[0.16; 8.17]-191 -NABérard, 2017 10.510.01.0

Umbrella review (other published meta-analyses)

Published MAControlPeriodTE95% CIn exposedkI2 Reefhuis (Craniosynostosis)Reefhuis (Craniosynostosis) 1.90[1.10; 3.00]NA-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT2 metaPregmetaPreg 1.89[1.24; 2.87]0%2,099----Anderson, 2020 Bérard, 2017 Wemakor, 2015 Malm, 2011 Louik, 2007 50.510.01.0