Paroxetine updated on 07-01-2025

Neonatal medical care

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.
S18437
R78176		 Lee (Controls exposed to TCAs), 2025 Admission to neonatal intensive care unit (NICU) 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, ...) 0.75 [0.17;3.27] C
excluded (control group) 		2/77   21/613 23 77
ref
S18419
R77934		 Lee (Controls unexposed, general pop), 2025 Admission to neonatal intensive care unit (NICU) 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, ...) 0.84 [0.21;3.45] 2/77   8,566/463,440 8,568 77
ref
S13126
R50044		 Marks (Controls exposed to Bupropion), 2021 Neonatal intensive care unit admission during pregnancy (anytime or not specified) retrospective cohort exposed to other treatment, sick Adjustment: Yes Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 1.64 [0.83;3.26] 16/55   91/406 107 55
ref
S7698
R22840		 Kivistö, 2016 Neonatal intensive care during pregnancy (anytime or not specified) retrospective cohort unexposed (general population or NOS) Adjustment: Yes Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 3.71 [1.66;8.26] -/32   2,431/24,402 - 32
ref
S564
R21073		 Maschi, 2008 Neonatal Intensive Care Unit (NICU)/Special Care Nursery (SCN) admissions during pregnancy (anytime or not specified) prospective cohort unexposed (general population or NOS) Adjustment: No Matched Monotherapy: no or not specified 1.00 [0.12;8.46] C 1/58   6/348 7 58
ref
S8043
R24474		 Oberlander, 2004 Poor neonatal adaptation (high level of medical care and observation) during pregnancy (anytime or not specified) prospective cohort unexposed, disease free Adjustment: No Monotherapy: substance alone among all Antidep (SSRI, SNRI, ...) 2.25 [0.33;15.24] C 3/17   2/23 5 17
ref
S6731
R19023		 Costei (Controls unexposed, NOS), 2002 Neonate respiratory distress 3rd trimester prospective cohort unexposed (general population or NOS) excluded Adjustment: No Matched Monotherapy: no or not specified 11.07 [0.62;197.91] C
excluded (control group) 		9/55   0/27 9 55
ref
S6732
R19026		 Costei (Controls unexposed, sick), 2002 Neonate respiratory distress 3rd trimester prospective cohort unexposed, sick Adjustment: No Matched Monotherapy: no or not specified Unexposed sick: recent illness/treatment (during or juste before pregnancy or treatment stopped in view of pregnancy) 5.09 [0.61;42.43] C 9/55   1/27 10 55
ref
Total 6 studies 2.07 [1.29;3.32] 8,697 294
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 0.84[0.21; 3.45]8,5687711%ROB confusion: moderateROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Marks (Controls exposed to Bupropion), 2021Marks, 2021 2 1.64[0.83; 3.26]1075542%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Kivistö, 2016Kivistö, 2016 3.71[1.66; 8.26]-3231%ROB confusion: seriousROB selection: criticalROB classification: moderateROB missing: criticalROB mesure: moderateROB reporting: moderate Maschi, 2008Maschi, 2008 1.00[0.12; 8.46]7585%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Oberlander, 2004Oberlander, 2004 2.25[0.33; 15.24]5176%ROB confusion: criticalROB selection: criticalROB classification: lowROB missing: lowROB mesure: moderateROB reporting: moderate Costei (Controls unexposed, sick), 2002Costei, 2002 3 5.09[0.61; 42.43]10555%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: criticalROB reporting: moderate Total (6 studies) I2 = 4% 2.07[1.29; 3.32]8,6972940.220.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, general pop; 2: Controls exposed to Bupropion; 3: Controls unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 2.07[1.29; 3.32]8,6972944%NALee (Controls unexposed, general pop), 2025 Marks (Controls exposed to Bupropion), 2021 Kivistö, 2016 Maschi, 2008 Oberlander, 2004 Costei (Controls unexposed, sick), 2002 6 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 2.05[0.93; 4.54]8,58018424%NALee (Controls unexposed, general pop), 2025 Kivistö, 2016 Maschi, 2008 Oberlander, 2004 4 unexposed, sickunexposed, sick 5.09[0.61; 42.43]1055 -NACostei (Controls unexposed, sick), 2002 1 exposed to other treatment, sickexposed to other treatment, sick 1.64[0.83; 3.25]10755 -NAMarks (Controls exposed to Bupropion), 2021 1 Tags Adjustment   - No  - No 2.26[0.69; 7.38]221300%NAMaschi, 2008 Oberlander, 2004 Costei (Controls unexposed, sick), 2002 3   - Yes  - Yes 1.95[0.93; 4.11]8,67516451%NALee (Controls unexposed, general pop), 2025 Marks (Controls exposed to Bupropion), 2021 Kivistö, 2016 3 MatchedMatched 2.27[0.46; 11.16]1711311%NAMaschi, 2008 Costei (Controls unexposed, sick), 2002 2 Monotherapy   - no or not specified  - no or not specified 2.27[0.46; 11.16]1711311%NAMaschi, 2008 Costei (Controls unexposed, sick), 2002 2   - substance alone among all Antidep ( ...  - substance alone among all Antidep (SSRI, SNRI, ...) 2.02[1.11; 3.66]8,68018126%NALee (Controls unexposed, general pop), 2025 Marks (Controls exposed to Bupropion), 2021 Kivistö, 2016 Oberlander, 2004 4 Unexposed sick   - recent illness/treatment (during o ...  - recent illness/treatment (during or juste before pregnancy or treatment stopped in view of pregnancy) 5.09[0.61; 42.43]1055 -NACostei (Controls unexposed, sick), 2002 1 All studiesAll studies 2.07[1.29; 3.32]8,6972944%NALee (Controls unexposed, general pop), 2025 Marks (Controls exposed to Bupropion), 2021 Kivistö, 2016 Maschi, 2008 Oberlander, 2004 Costei (Controls unexposed, sick), 2002 60.220.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-2.63.31.3070.000Lee (Controls unexposed, general pop), 2025Marks (Controls exposed to Bupropion), 2021Kivistö, 2016Maschi, 2008Oberlander, 2004Costei (Controls unexposed, sick), 2002

Asymetry test p-value = 0.8297 (by Egger's regression)

slope=0.8532 (0.5975); intercept=-0.2433 (1.0601); t=0.2295; p=0.8297

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 6731, 18437

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 2.30[1.07; 4.92]11,01123920%NALee (Controls unexposed, general pop), 2025 Kivistö, 2016 Maschi, 2008 Oberlander, 2004 Costei (Controls unexposed, NOS), 2002 5 unexposed, sick controlsunexposed, sick controls 5.09[0.61; 42.43]1055 -NACostei (Controls unexposed, sick), 2002 1 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.43[0.77; 2.65]1301320%NALee (Controls exposed to TCAs), 2025 Marks (Controls exposed to Bupropion), 2021 20.510.01.0