Fluoxetine updated on 07-01-2025

Urinary malformations

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
R21945		 Bérard, 2017 Urinary 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) 0.56 [0.08;4.00] -/191   -/14,847 - 191
ref
S7354
R21618		 Jordan, 2016 Urinary 3 months or more before pregnancy or1st trimester excluded retrospective cohort (registry) unexposed (general population or NOS) Adjustment: No Monotherapy: no or not specified 1.69 [0.98;2.93] C
excluded (exposition period) 		13/2,601   1,496/506,155 1,509 2,601
ref
S5882
R14693		 Ban (Controls unexposed, disease free), 2014 Urinary system malformations 1st trimester retrospective cohort (claims database) unexposed, disease free Adjustment: Yes Monotherapy: substance alone among the specific class of antidep (SSRI, SNRI, ...) 1.14 [0.59;2.19] -/3,189   815/325,294 - 3,189
ref
S6016
R15533		 Jimenez-Solem (Controls unexposed, NOS), 2012 Congenital malformations of the internal urinary system 1st trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: No Monotherapy: substance alone among the specific class of antidep (SSRI, SNRI, ...) 0.19 [0.01;3.11] C 0/928   2,333/843,797 2,333 928
ref
S6157
R16122		 Louik, 2007 Renal-collecting-system defects 1st trimester case control unexposed (general population or NOS) Adjustment: Yes Monotherapy: substance alone among the specific class of antidep (SSRI, SNRI, ...) 1.00 [0.50;2.30] 5/66   639/6,438 644 66
ref
Total 4 studies 0.99 [0.61;1.59] 2,977 4,374
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 0.56[0.08; 4.00]-1916%ROB confusion: seriousROB selection: moderateROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Ban (Controls unexposed, disease free), 2014Ban, 2014 1 1.14[0.59; 2.19]-3,18952%ROB confusion: seriousROB selection: moderateROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Jimenez-Solem (Controls unexposed, NOS), 2012Jimenez-Solem, 2012 2 0.19[0.01; 3.11]2,3339283%ROB confusion: criticalROB selection: moderateROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: critical Louik, 2007Louik, 2007 1.00[0.50; 2.30]6446639%ROB confusion: moderateROB selection: criticalROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Total (4 studies) I2 = 0% 0.99[0.61; 1.59]2,9774,3740.05.01.0ROB: 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 0.98[0.53; 1.79]2,3334,3080%NABérard, 2017 Ban (Controls unexposed, disease free), 2014 Jimenez-Solem (Controls unexposed, NOS), 2012 3 case control studiescase control studies 1.00[0.47; 2.14]64466 -NALouik, 2007 1 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.02[0.63; 1.67]2,9774,1830%NABan (Controls unexposed, disease free), 2014 Jimenez-Solem (Controls unexposed, NOS), 2012 Louik, 2007 3 unexposed, sickunexposed, sick 0.56[0.08; 3.96]-191 -NABérard, 2017 1 Tags Adjustment   - No  - No 0.19[0.01; 3.11]2,333928 -NAJimenez-Solem (Controls unexposed, NOS), 2012 1   - Yes  - Yes 1.04[0.64; 1.68]6443,4460%NABérard, 2017 Ban (Controls unexposed, disease free), 2014 Louik, 2007 3 Monotherapy   - substance alone among all Antidep ( ...  - substance alone among all Antidep (SSRI, SNRI, ...) 0.56[0.08; 3.96]-191 -NABérard, 2017 1   - substance alone among the specific ...  - substance alone among the specific class of antidep (SSRI, SNRI, ...) 1.02[0.63; 1.67]2,9774,1830%NABan (Controls unexposed, disease free), 2014 Jimenez-Solem (Controls unexposed, NOS), 2012 Louik, 2007 3 Unexposed sick   - intermediate history of illness/tre ...  - intermediate history of illness/treatment (3-12 months before pregnancy) 0.56[0.08; 3.96]-191 -NABérard, 2017 1 All studiesAll studies 0.99[0.61; 1.59]2,9774,3740%NABérard, 2017 Ban (Controls unexposed, disease free), 2014 Jimenez-Solem (Controls unexposed, NOS), 2012 Louik, 2007 40.05.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.33.31.6980.000Bérard, 2017Ban (Controls unexposed, disease free), 2014Jimenez-Solem (Controls unexposed, NOS), 2012Louik, 2007

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

not enought points

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) 1.02[0.63; 1.67]3,7834,1830%NABan (Controls unexposed, disease free), 2014 Jimenez-Solem (Controls unexposed, NOS), 2012 Louik, 2007 3 unexposed, sick controlsunexposed, sick controls 0.56[0.08; 3.96]-191 -NABérard, 2017 10.510.01.0