Fluoxetine updated on 07-01-2025

Low Apgar score (< 7) (at 1 min)

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.
S18436
R78152		 Lee (Controls exposed to TCAs), 2025 1-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, ...) 0.90 [0.55;1.45] C
excluded (control group) 		36/719   34/613 70 719
ref
S18415
R77847		 Lee (Controls unexposed, general pop), 2025 1-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, ...) 1.33 [0.94;1.88] 36/719   14,883/463,440 14,919 719
ref
S7693
R22799		 Kivistö, 2016 Low (<7) Apgar score at 1 min during pregnancy (anytime or not specified) retrospective cohort unexposed (general population or NOS) Adjustment: Yes Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 2.42 [1.06;5.54] -/51   1,451/24,402 - 51
ref
Total 2 studies 1.59 [0.93;2.71] 14,919 770
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 Lee (Controls unexposed, general pop), 2025Lee, 2025 1 1.33[0.94; 1.88]14,91971970%ROB confusion: moderateROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Kivistö, 2016Kivistö, 2016 2.42[1.06; 5.54]-5130%ROB confusion: seriousROB selection: criticalROB classification: moderateROB missing: criticalROB mesure: moderateROB reporting: moderate Total (2 studies) I2 = 42% 1.59[0.93; 2.71]14,9197700.55.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, general pop;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.59[0.93; 2.71]14,91977042%NALee (Controls unexposed, general pop), 2025 Kivistö, 2016 2 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.59[0.93; 2.71]14,91977042%NALee (Controls unexposed, general pop), 2025 Kivistö, 2016 2 Tags Adjustment   - Yes  - Yes 1.59[0.93; 2.71]14,91977042%NALee (Controls unexposed, general pop), 2025 Kivistö, 2016 2 Monotherapy   - substance alone among all Antidep ( ...  - substance alone among all Antidep (SSRI, SNRI, ...) 1.59[0.93; 2.71]14,91977042%NALee (Controls unexposed, general pop), 2025 Kivistö, 2016 2 All studiesAll studies 1.59[0.93; 2.71]14,91977042%NALee (Controls unexposed, general pop), 2025 Kivistö, 2016 20.55.01.0

Publication bias and p-hacking diagnosis

funnel plot

Funnel plot not drawn. Less than 3 points.

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

not enought points

p values plot

Funnel plot not drawn. Less than 3 points.

Sub-groups analysis using all included studies

excluded 18436

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.59[0.93; 2.71]16,36177042%NALee (Controls unexposed, general pop), 2025 Kivistö, 2016 2 exposed to other treatment, sick controlsexposed to other treatment, sick controls 0.90[0.55; 1.45]70719 -NALee (Controls exposed to TCAs), 2025 10.510.01.0