Selective Serotonin Reuptake Inhibitor (SSRI) updated on 07-01-2025

Club foot / Talipes equinovarus

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.
S516
R15358		 Furu (Controls unexposed, NOS), 2015 Clubfoot 1st trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes Monotherapy: SSRI only 1.34 [1.05;1.71] 77/36,772   3,174/2,266,875 3,251 36,772
ref
S7348
R21406		 Wemakor, 2015 Club foot 1st trimester case control unexposed (general population or NOS) Adjustment: Yes Monotherapy: SSRI only 2.41 [1.59;3.65] 30/129   1,962/18,946 1,992 129
ref
S7605
R23940		 Yazdy, 2014 Club foot 1st trimester case control unexposed, disease free Adjustment: Yes Monotherapy: no or not specified 1.80 [1.10;2.80] 33/91   589/2,533 622 91
ref
S493
R15257		 Colvin, 2011 Talipes 1st trimester retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No Monotherapy: no or not specified 1.52 [0.75;3.08] 8/2,701   185/94,561 193 2,701
ref
S5424
R16106		 Louik, 2007 Clubfoot 1st trimester case control unexposed (general population or NOS) Adjustment: Yes Monotherapy: no or not specified 2.20 [1.40;3.60] 20/180   393/6,093 413 180
ref
Total 5 studies 1.77 [1.36;2.31] 6,471 39,873
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 Furu (Controls unexposed, NOS), 2015Furu, 2015 1 1.34[1.05; 1.71]3,25136,77232%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Wemakor, 2015Wemakor, 2015 2.41[1.59; 3.65]1,99212921%ROB confusion: criticalROB selection: criticalROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Yazdy, 2014Yazdy, 2014 1.80[1.10; 2.80]6229118%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Colvin, 2011Colvin, 2011 1.52[0.75; 3.08]1932,70111%ROB confusion: criticalROB selection: moderateROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Louik, 2007Louik, 2007 2.20[1.40; 3.60]41318018%ROB confusion: moderateROB selection: criticalROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Total (5 studies) I2 = 47% 1.77[1.36; 2.31]6,47139,8730.55.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, NOS;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.36[1.08; 1.71]3,44439,4730%NAFuru (Controls unexposed, NOS), 2015 Colvin, 2011 2 case control studiescase control studies 2.14[1.65; 2.78]3,0274000%NAWemakor, 2015 Yazdy, 2014 Louik, 2007 3 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.77[1.36; 2.31]6,47139,87347%NAFuru (Controls unexposed, NOS), 2015 Wemakor, 2015 Yazdy, 2014 Colvin, 2011 Louik, 2007 5 Tags Adjustment   - No  - No 1.52[0.75; 3.08]1932,701 -NAColvin, 2011 1   - Yes  - Yes 1.82[1.34; 2.48]6,27837,17260%NAFuru (Controls unexposed, NOS), 2015 Wemakor, 2015 Yazdy, 2014 Louik, 2007 4 Monotherapy   - no or not specified  - no or not specified 1.89[1.40; 2.56]1,2282,9720%NAYazdy, 2014 Colvin, 2011 Louik, 2007 3   - SSRI only  - SSRI only 1.75[0.99; 3.11]5,24336,90182%NAFuru (Controls unexposed, NOS), 2015 Wemakor, 2015 2 All studiesAll studies 1.77[1.36; 2.31]6,47139,87347%NAFuru (Controls unexposed, NOS), 2015 Wemakor, 2015 Yazdy, 2014 Colvin, 2011 Louik, 2007 50.55.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-1.11.40.4320.000Furu (Controls unexposed, NOS), 2015Wemakor, 2015Yazdy, 2014Colvin, 2011Louik, 2007

Asymetry test p-value = 0.2772 (by Egger's regression)

slope=0.1064 (0.3224); intercept=2.1722 (1.6400); t=1.3245; p=0.2772

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) 1.77[1.36; 2.31]6,47139,87347%NAFuru (Controls unexposed, NOS), 2015 Wemakor, 2015 Yazdy, 2014 Colvin, 2011 Louik, 2007 50.510.01.0

Umbrella review (other published meta-analyses)

Published MAControlPeriodTE95% CIn exposedkI2 Chen - SSRI (Clubfoot)Chen - SSRI (Clubfoot) 1.78[1.34; 2.37]60 %-Wwhatever (meta-analysis)T11st trimesterstudies TTT4 Gao - SSRI (Clubfoot)Gao - SSRI (Clubfoot) 1.30[1.06; 1.61]-U,GPunexposed (general population or NOS)T11st trimesterstudies TTT2 metaPregmetaPreg 1.77[1.36; 2.31]47%39,873----Furu (Controls unexposed, NOS), 2015 Wemakor, 2015 Yazdy, 2014 Colvin, 2011 Louik, 2007 50.510.01.0