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

Limb reduction defects (LRD)

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
R15359		 Furu (Controls unexposed, NOS), 2015 Limb reduction 1st trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes Monotherapy: SSRI only 0.97 [0.59;1.62] 17/36,772   1,031/2,266,875 1,048 36,772
ref
S7348
R21410		 Wemakor, 2015 Limb reduction 1st trimester case control unexposed (general population or NOS) Adjustment: Yes Monotherapy: SSRI only 1.15 [0.50;2.65] 6/105   778/17,762 784 105
ref
S495
R76922		 Källén, 2007 Limb-reduction defects early pregnancy population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes Monotherapy: SSRI only 0.44 [0.05;1.59] 2/6,555   671/873,876 673 6,555
ref
S5424
R16112		 Louik, 2007 Limb-reduction defects 1st trimester case control unexposed (general population or NOS) Adjustment: Yes Monotherapy: no or not specified 1.70 [0.90;3.40] 9/169   184/5,884 193 169
ref
Total 4 studies 1.14 [0.80;1.62] 2,698 43,601
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 0.97[0.59; 1.62]1,04836,77249%ROB confusion: criticalROB selection: moderateROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Wemakor, 2015Wemakor, 2015 1.15[0.50; 2.65]78410518%ROB confusion: criticalROB selection: criticalROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Källén, 2007Källén, 2007 0.44[0.05; 1.59]6736,5554%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: lowROB mesure: unclearROB reporting: moderate Louik, 2007Louik, 2007 1.70[0.90; 3.40]19316928%ROB confusion: moderateROB selection: criticalROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Total (4 studies) I2 = 0% 1.14[0.80; 1.62]2,69843,6010.25.01.0ROB: 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 0.91[0.56; 1.48]1,72143,3270%NAFuru (Controls unexposed, NOS), 2015 Källén, 2007 2 case control studiescase control studies 1.46[0.87; 2.46]9772740%NAWemakor, 2015 Louik, 2007 2 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.14[0.80; 1.62]2,69843,6010%NAFuru (Controls unexposed, NOS), 2015 Wemakor, 2015 Källén, 2007 Louik, 2007 4 Tags Adjustment   - Yes  - Yes 1.14[0.80; 1.62]2,69843,6010%NAFuru (Controls unexposed, NOS), 2015 Wemakor, 2015 Källén, 2007 Louik, 2007 4 Monotherapy   - no or not specified  - no or not specified 1.70[0.87; 3.30]193169 -NALouik, 2007 1   - SSRI only  - SSRI only 0.97[0.64; 1.47]2,50543,4320%NAFuru (Controls unexposed, NOS), 2015 Wemakor, 2015 Källén, 2007 3 All studiesAll studies 1.14[0.80; 1.62]2,69843,6010%NAFuru (Controls unexposed, NOS), 2015 Wemakor, 2015 Källén, 2007 Louik, 2007 40.25.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-2.12.21.0590.000Furu (Controls unexposed, NOS), 2015Wemakor, 2015Källén, 2007Louik, 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) 1.14[0.80; 1.62]2,69843,6010%NAFuru (Controls unexposed, NOS), 2015 Wemakor, 2015 Källén, 2007 Louik, 2007 40.510.01.0