Fluoxetine updated on 07-01-2025

Respiratory system anomalies

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.
S7438
R21942		 Bérard, 2017 Respiratory system malformations 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) 1.93 [0.47;7.85] -/191   -/14,847 - 191
ref
S7349
R21475		 Wemakor, 2015 Respiratory system anomalies 1st trimester case control unexposed (general population or NOS) Adjustment: No Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 0.64 [0.09;4.74] C 1/28   982/18,038 983 28
ref
S5882
R14701		 Ban (Controls unexposed, disease free), 2014 Respiratory system malformations 1st trimester retrospective cohort (claims database) unexposed, disease free Adjustment: Yes Monotherapy: substance alone among the specific class of antidep (SSRI, SNRI, ...) 1.90 [0.71;5.09] -/3,189   205/325,294 - 3,189
ref
S6016
R15540		 Jimenez-Solem (Controls unexposed, NOS), 2012 Malformations of the respiratory system 1st trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes Monotherapy: substance alone among the specific class of antidep (SSRI, SNRI, ...) 0.94 [0.13;6.67] 1/928   -/843,797 - 928
ref
S7194
R20423		 Colvin, 2011 Respiratory system defects 1st trimester retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No Monotherapy: substance alone among the specific class of antidep (SSRI, SNRI, ...) 1.92 [0.12;31.09] C 0/291   84/94,561 84 291
ref
S6242
R16495		 Malm, 2011 Respiratory tract 1st trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes Monotherapy: no or not specified 1.03 [0.33;3.25] -/1,818   -/628,607 - 1,818
ref
Total 6 studies 1.39 [0.78;2.50] 1,067 6,445
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 Bérard, 2017Bérard, 2017 1.93[0.47; 7.85]-19117%ROB confusion: seriousROB selection: moderateROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Wemakor, 2015Wemakor, 2015 0.64[0.09; 4.74]983289%ROB confusion: criticalROB selection: criticalROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Ban (Controls unexposed, disease free), 2014Ban, 2014 1 1.90[0.71; 5.09]-3,18935%ROB confusion: seriousROB selection: moderateROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Jimenez-Solem (Controls unexposed, NOS), 2012Jimenez-Solem, 2012 2 0.94[0.13; 6.67]-9289%ROB confusion: criticalROB selection: moderateROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: critical Colvin, 2011Colvin, 2011 1.92[0.12; 31.09]842914%ROB confusion: criticalROB selection: moderateROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Malm, 2011Malm, 2011 1.03[0.33; 3.25]-1,81826%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Total (6 studies) I2 = 0% 1.39[0.78; 2.50]1,0676,4450.25.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, disease free; 2: Controls unexposed, NOS;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.50[0.81; 2.76]846,4170%NABérard, 2017 Ban (Controls unexposed, disease free), 2014 Jimenez-Solem (Controls unexposed, NOS), 2012 Colvin, 2011 Malm, 2011 5 case control studiescase control studies 0.64[0.09; 4.74]98328 -NAWemakor, 2015 1 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.30[0.69; 2.47]1,0676,2540%NAWemakor, 2015 Ban (Controls unexposed, disease free), 2014 Jimenez-Solem (Controls unexposed, NOS), 2012 Colvin, 2011 Malm, 2011 5 unexposed, sickunexposed, sick 1.93[0.47; 7.89]-191 -NABérard, 2017 1 Tags Adjustment   - No  - No 0.93[0.18; 4.73]1,0673190%NAWemakor, 2015 Colvin, 2011 2   - Yes  - Yes 1.48[0.79; 2.76]-6,1260%NABérard, 2017 Ban (Controls unexposed, disease free), 2014 Jimenez-Solem (Controls unexposed, NOS), 2012 Malm, 2011 4 Monotherapy   - no or not specified  - no or not specified 1.03[0.33; 3.23]-1,818 -NAMalm, 2011 1   - substance alone among all Antidep ( ...  - substance alone among all Antidep (SSRI, SNRI, ...) 1.34[0.42; 4.24]9832190%NABérard, 2017 Wemakor, 2015 2   - substance alone among the specific ...  - substance alone among the specific class of antidep (SSRI, SNRI, ...) 1.67[0.72; 3.88]844,4080%NABan (Controls unexposed, disease free), 2014 Jimenez-Solem (Controls unexposed, NOS), 2012 Colvin, 2011 3 Unexposed sick   - intermediate history of illness/tre ...  - intermediate history of illness/treatment (3-12 months before pregnancy) 1.93[0.47; 7.89]-191 -NABérard, 2017 1 All studiesAll studies 1.39[0.78; 2.50]1,0676,4450%NABérard, 2017 Wemakor, 2015 Ban (Controls unexposed, disease free), 2014 Jimenez-Solem (Controls unexposed, NOS), 2012 Colvin, 2011 Malm, 2011 60.25.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.33.71.7040.000Bérard, 2017Wemakor, 2015Ban (Controls unexposed, disease free), 2014Jimenez-Solem (Controls unexposed, NOS), 2012Colvin, 2011Malm, 2011

Asymetry test p-value = 0.4831 (by Egger's regression)

slope=0.7281 (0.5435); intercept=-0.5755 (0.7454); t=0.7721; p=0.4831

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) 1.30[0.69; 2.47]1,2636,2540%NAWemakor, 2015 Ban (Controls unexposed, disease free), 2014 Jimenez-Solem (Controls unexposed, NOS), 2012 Colvin, 2011 Malm, 2011 5 unexposed, sick controlsunexposed, sick controls 1.93[0.47; 7.89]-191 -NABérard, 2017 10.510.01.0

Umbrella review (other published meta-analyses)

Published MAControlPeriodTE95% CIn exposedkI2 Gao (Respiratory system anomalies)Gao (Respiratory system anomalies) 1.38[0.69; 2.78]0%-Wwhatever (meta-analysis)T11st trimesterstudies TTT3 metaPregmetaPreg 1.39[0.78; 2.50]0%6,445----Bérard, 2017 Wemakor, 2015 Ban (Controls unexposed, disease free), 2014 Jimenez-Solem (Controls unexposed, NOS), 2012 Colvin, 2011 Malm, 2011 60.510.01.0